Have you ever shared your health concerns with your doctor only to be told that your labs are normal so there’s nothing wrong with you? Or worse—it’s all in your head?

One of the most frustrating positions to be in as a patient is knowing things are going on with your health, but your very valid concerns are being dismissed because your lab results are normal. It’s a form of gaslighting, and I’m not okay with it! You deserve better!

If you’re experiencing chronic symptoms, that means imbalances and dysfunction are present. To put it simply, chronic symptoms are your body’s way of telling you that something’s going on and you need to give your body support and make some changes.

And while lab testing can provide some incredibly helpful insight into what’s going on, the inconvenient reality is that you can have very real health issues present that don’t show up as abnormal test results.

Normal Labs vs. Optimal Labs

Normal reference ranges for labs are really intended to identify the presence of disease—as it’s defined by conventional medicine. But these reference ranges are NOT designed to evaluate whether your labs are optimal for health—and there’s a difference!

It’s also important to note that the normal reference range can vary from lab company to lab company, and depending on which part of the US you live in. Why? Because the normal reference range is affected by the average finding for that particular marker, which means the health of the average person in that area can impact where that reference range starts and ends. And because there can be significant variability from one person to the next, normal reference ranges can also be quite large. 

One important point to keep in mind is that the average person in the US is NOT optimally healthy! So if these reference ranges are not built around optimal health, can they actually be used to identify…health? After all, health is much more than the absence of disease.  

It’s also important to remember that conventional medicine is a retroactive disease-based model. “Retroactive” meaning that your health isn’t a focus until you’ve got a collection of symptoms or abnormal labs that can be labeled with a diagnosis. “Disease-based” meaning that the focus is on managing symptoms, not on building health. So it makes total sense that normal reference ranges are based on identifying disease and NOT health—and yes, this distinction does matter!

And lastly, when it comes to health, “common” is not the same thing as “normal.” Chronic symptoms may be common, but they are NOT normal. Let’s stop normalizing dysfunctions in health just because we live in a society where chronic disease is so common!

As a naturopathic doctor, I learned to evaluate labs using normal AND functional ranges (which are more narrow and specific than normal lab ranges). Functional ranges aren’t about diagnosing disease. They are about finding trends and identifying a potential health imbalance before it becomes a diagnosable disease. Whereas normal ranges are based on disease, functional ranges are based on optimal health—which is exactly what I want for my patients!

Normal vs. Optimal: Thyroid Testing

Let’s look at an example using TSH (thyroid stimulating hormone), which is routinely ordered to evaluate thyroid function. 

Although there’s some slight variability in ranges, the normal reference range for TSH is usually around 0.45-4.5 mIU/L. Does this mean that someone who has a TSH of 4.5 has perfectly healthy thyroid function, but someone with a TSH of 4.6 does not? Or that someone with a TSH of 0.45 is just fine, but once it drops to 0.44 they’ve got a problem?

Of course not! Because the reality is that health and disease are on a spectrum. You aren’t perfectly healthy, and then boom—you have a chronic health condition. That’s just not how the body works! For chronic disease to develop, there has to be a journey away from health that occurs over time. 

This is why solely looking at whether labs fall into the normal reference range can miss important clues as to what’s brewing under the surface and the trajectory that your health is on.

So what’s the solution?

Gaining insight into how your body is functioning by using ranges that are structured around optimal health, of course!

Let’s return to our example of TSH. The functional range for TSH that I use is 1-2.5 mIU/L.

Does this mean that if your TSH is less than 1 mIU/L, you have hyperthyroidism? Or if your TSH is above 2.5 mIU/L you have hypothyroidism? 

No! A formal diagnosis of hypothyroidism or hyperthyroidism means that results are outside of the normal reference range.

But, if your TSH is less than 1 mIU/L or greater than 2.5 mIU/L, this can indicate the presence of thyroid dysfunction that may be playing a role in your symptoms. Put another way, values outside the functional range can indicate non-optimal physiology that can cause or contribute to symptoms. 

The bonus? Identifying dysfunction before it becomes a diagnosable health condition resulting in abnormal lab tests allows YOU the opportunity to take action, make the appropriate changes, and give your body the support it needs so that you can bring your health into greater balance. This is true preventive medicine!

Please understand this is a VERY simplified example. There are actually several additional markers that should be ordered to evaluate the health of your thyroid. Check out my article on thyroid testing to learn more!

Functional Lab Analysis Can Help to Provide the Missing Pieces to Your Health Puzzle

My primary goal when working with patients is to optimize health, and I’ve found that analyzing labs from a functional perspective can provide the missing insight that’s needed to better understand the particular health imbalances you’re facing. And when you understand your health imbalances, you can address them!

If you’re being told that your labs are normal so nothing is wrong with you, I highly recommend working with a provider, such as a naturopathic doctor, who is trained in functional lab interpretation! Time and again, I have seen this approach help patients to address the root causes of their chronic symptoms—whether we’re talking about fatigue, sleep disturbances, difficulty losing weight, brain fog, headaches, chronic pain, gut issues, hormonal imbalances, immune system dysfunction, and more!

Is Your Doctor Actually Ordering “All the Labs”?

I routinely work with women who have been to multiple doctors and had “all the labs” run, most of which came back in the normal range. However, the reality is that there are far more testing options available than what conventional providers typically utilize (or even know about). 

As an example, I routinely see conventional providers run the following labs at annual visits:

1. Complete Blood Count (CBC), often without a differential
2. Comprehensive Metabolic Panel (CMP), but sometimes just a Basic Metabolic Panel (BMP)
3. A1c (maybe)
4. TSH (perhaps also with total or free T4)
5. lipid panel (cholesterol, triglycerides LDL, HDL)

Occasionally, I also see vitamin D and B12 ordered, and sometimes hormones like estradiol, progesterone, and testosterone though this isn’t very common.

In contrast, the standard annual panel I want to see on all of my patients includes over 30 panels and markers, and those additional tests can provide some seriously helpful insight (especially when the results are also evaluated from a functional perspective)!

Specialty Functional Tests: Beyond Bloodwork

Over the years, I’ve seen specialty functional tests—like comprehensive stool analysis, 4-point adrenal function testing, environmental toxin evaluations, and urinary and salivary hormone panels—provide much-needed insight into how these different areas are functioning. 

These tests are less focused on identifying disease (though they often can) and more focused on identifying imbalances that can impact your health.  Much like functional bloodwork analysis and expanded bloodwork panels can give you useful information about your health, specialty functional tests can as well!

You Know Your Body Better Than Anyone Else!

If you’ve hit a road block with your doctors or your quest to understand the root causes of your symptoms, consider that additional testing outside of the realm of conventional medicine could give you the answers you’re looking for. 

Don’t let the limitations of the conventional medical model impede your ability to understand what’s going on with your health! You deserve to be armed with information so you can support and heal your body!

Here’s to you getting the insight you need so that you can rebuild your health from the inside out!

Want personalized guidance? Learn how my approach can help you uncover and address the root causes of your symptoms here.