Labwork Results: “Normal” Versus Optimal

Today’s topic is “normal” nutrition related labwork, but usually it’s not really so normal

Labs show data about the human body in quantifiable values that can be tested and if 95% of the population falls into a certain parameter, this is where the term “normal” labwork comes from. There is a lot of back and forth on this topic for “where to draw the line” when it comes to normal versus abnormal and how this trickles down to health related guidance. This is a hot topic in healthcare, especially nutrition related healthcare!

On a grand scale, healthcare professionals are arguably quick to say “everything is normal; you are fine.” Fine is so subjective. And the line drawn between “normal” and “abnormal” is a gray one.

Patients report feeling gaslit at times when told they are fine, especially when their symptoms and concerns are lingering.

Medical gaslighting can succinctly be described as a patient’s symptoms being dismissed or told that their symptoms are psychological and “all in their head.” Of course, gaslighting is not occurring in all encounters, labs of course can be accurate for the situation, and there are psycho-somatic instances out there.

But is the conventional system casting too wide of a net when it comes to “normal” labwork? Could we guide patients towards thriving rather than just surviving? I say we should! Optimal labwork is another big topic in healthcare and is gaining a lot of headway in the Functional Medicine and Functional Nutrition world.

As a registered dietitian and in the context of talking about labwork, this data is essential input for when it comes to making nutrition related interventions for patients. I order labwork (or obtain labwork from the patient’s care team) to help in making specific care plans. When assessing a patient for nutritional adequacy (meaning are they getting enough of what they should and not too much of what they shouldn’t), I believe and research shows labwork is valuable.

I often say the expression “test, don’t guess” and put it into motion when it comes to obtaining labwork. After obtaining baseline labwork and then analyzing the results, the numbers help determine the nutrition plan. I aim to guide patients towards optimal results, not just normal and I’ll explain this more.

Below shows that some labs are all “normal” or “within normal limits” but there is a DIFFERENCE between the following nutrition related labs:

• A 25-hydroxy vitamin D lab of 30ng/dL versus 52ng/dL
• A serum ferritin lab of 22ng/mL versus 73ng/dL
• A vitamin B12 lab of 312pg/mL versus 754pg/mL
• A reverse T3 of 23ng/dL versus 12ng/dL
• A hemoglobin a1c of 5.5% versus 4.8%
• A zinc of 71mcg/dL versus a zinc of 108mcg/dL
• And so many more examples!

Yes, for certain biomarkers, anywhere is the normal range is adequate, but for many types of labs, being barely in the “normal range” can make a big DIFFERENCE in terms of how the body functions and how the patient feels. Here is a very loose analogy: D is still a passing grade but there is a difference between a D and an A.

Health is on a spectrum, but so often gets lumped into “normal” or “abnormal” categories.

These above nutrition related labs help illustrate this concept. A patient may still fatigue with a vitamin D of 30ng/dL, even thought its “in the normal range.” I recommend aiming for 50-60ng/dL where many report feeling better and emerging research shows this helps better manage various chronic illnesses.

Another example, a patient can have a barely passing grade of a ferritin of 22ng/mL but hair shedding could be occurring and/or fatigue and/or irritability. This is technically a normal range but it is not ideal. Ideal is much higher and when symptoms often improve.

My goal is to help patients not just pass, but get an excellent score. Thrive not survive. Tailoring care plans and optimizing nutrition are my areas of specialty.

Schedule your own functional nutrition consult package if you are interested in optimizing health if “normal” just isn’t cutting it for you.