Why normal isn’t always optimal on lab work

If you have ever looked at your lab results, you may have noticed the reference range provided for each lab marker, telling you and your healthcare provider what a normal range is. Each lab marker has a reference range to serve as a guide for interpreting the results. 

Ever wonder how these reference ranges are established? 

I used to think the reference ranges were based on scientific research. Sadly, this is not the case. While research may inform some of the reference ranges, it’s not the full picture. Rather, the reference ranges on a lab test represent a bracket into which 95% of results fall within your local area. These numbers are hugely based off of a sick population. Sounds harsh, right? Well, next time you go to the grocery story, the library, to a restaurant, look around you. Where I live in the Deep South, the reference ranges I see on lab markers are based on a mostly obese and diabetic population.

This is why it is so important to understand that a reference range is a measure of average, not optimal. Sadly, the average individual is not healthy. The vast majority of the population where I live fails to get outside daily for vitamin D, fails to move their bodies daily, eats heavily processed foods, and consumes too much sugar. As a practitioner, I want my clients lab results to fall within a functional or optimal range for continued health and wellbeing. I work with them closely to achieve this. 

I frequently work with clients who have low energy, are short of breath, and always exhausted. According to labs and their PCP, they have ‘normal’ iron levels. And yet they are still experiencing the classic symptoms of iron deficiency. Often these clients fall right on the cusp, meaning they’re within range, but right at the very bottom of it. When I work with clients, I go by their clinical signs (such as what their labs are telling me) but also their symptoms (e.g. their fatigue and low energy).

Interestingly enough, while some reference ranges vary depending on age and gender, many are standard across the board, meaning the same range is used for a seven-year-old girl or a sixty-year-old man. These are two very different people with vastly different nutritional needs, different risk factors for disease, and different patterns of growth and development; what may be ideal for one may not be ideal for the other. This is why lab test results must always be interpreted in the context of the individual client—their age, gender, family history, medical history, nutritional requirements, and more—should all be part of determining their level of health and wellness.

In my practice, I look at patterns in blood work in two ways. I consider the patterns I see when I look at certain groups of markers and I consider the changing patterns on lab results that occur over time. There might be a slow, albeit persistent decrease in iron levels, or perhaps a slow but steady increase in total cholesterol. I note these changes, determine why they are occurring,  and if necessary, implement strategies to bring things back into balance before they become a full blown problem.

I encourage my clients to take responsibility for their health and ask questions. With persistence, you can become your own best healer; no one knows your body as well as you do. If you have been told your labs are ‘fine’ yet you’re still experiencing symptoms, seek a second opinion!