Why normal blood test results may not be normal

One of the most infuriating things clients often say they experience is being told their blood tests are all “normal”. This is particularly the case in my clients who are suffering from a range of symptoms affecting quality of life and are looking for some answers.

When it comes to analysing blood results it can pay to look at them from a different perspective. Low-normal or high-normal results can begin to indicate undesirable shifts from health long before they present as a disease state or known pathology.

Looking at your blood tests through a new lens

The change from ‘normal’ to ‘abnormal’ may be gradual and can take many years. Diabetes is a good example of this – glucose levels gradually increase until it is finally diagnosed. I want to be picking up on these subtle changes in your results long before they become a disease state and work with you to prevent the disease in the first place.

How do they determine what is normal for a diagnostic test?

To define a reference range, the first step is to define a “healthy” population to compare to. Defining what is “healthy” is hard (and I would argue that definition varies depending on the lens you are looking through). What it’s based on is the results from a group of people who don’t have the disease they’re trying to identify. A variation of around 2 standard deviations is then allowed, essentially representing the values found in 95% of individuals in the chosen non-diseased or “reference” group.

Let’s make something clear.

An absence of a particular disease does not necessarily make someone healthy.

Thus, not everyone who makes up this non-diseased reference group will be in an optimal state of health. This must be taken in to context when looking at pathology results and determining where our ideal levels sits. When it comes to certain nutritional markers “normal” rarely equates with what we perceive to be optimal, and in the face of specific disease states, potentially higher levels are required.

Sometimes it’s the balance between two markers that provides key clues.

Take for example Albumin and Globulin. The ratio between these two is a more subtle marker of inflammation, indicating a more general or “bigger picture” inflammatory state. Both of these markers may be in the normal range, but when you look at the balance between them, it points to a less than ideal scenario in your body.

Did you know there’s certain markers in the blood that may indicate a “busyness” in the bones? When elevated above an ideal value without other explanation (yet still in the range of what’s considered normal), I will consider speaking to your GP about bone density screening. This can be a very non-invasive way to pick up on increased bone loss, osteopenia or osteoporosis, especially in populations where perhaps it’s not expected yet and bone density screening isn’t usually offered.

TSH (a marker for thyroid health and function) is another hormone where levels still within the “normal” range may be indicating early signs of dysfunction. Often, I see a pattern emerge over time that TSH has been indicating all is not well with the thyroid. However, it is not until TSH is completely out of range that it’s agreed there’s an issue with the thyroid and action is taken.

Homocysteine is another marker that can indicate increased disease risk whilst still in the “normal range”. Again, we prefer to be picking up on these early warning signs and doing what we can to prevent further disease progress.

So if you’re not feeling well, yet your blood tests are all normal, perhaps it’s time to take another look from a new perspective?