WHY DO I STILL HAVE SYMPTOMS WHEN MY BLOOD/LAB TESTS ARE NORMAL?
One of the biggest concerns that functional medicine practitioners often hear from their new patients is that they will state they have had numerous lab tests run on them in the past for various biomarkers such as thyroid stimulating hormone (TSH), glucose and triglycerides but they have always been told that their lab findings are within normal ranges.
And this doesn’t sit well with the patient because they know that something is wrong since they are experiencing real life symptoms such as fatigue, moodiness, depression, brain fog, joint pain, gas, bloating, on a daily basis. So, they are usually left frustrated, feeling like no one can help them, and sometimes their very own integrity and truthfulness regarding their health is questioned by others, including doctors, further making matters worse.
IT IS CRITICAL YOU UNDERSTAND THE FOLLOWING
But, more often than not, the reason for this disconnect between a patient’s current health status and their apparently “normal” lab findings comes down to how their tests are being analyzed in the first place.
So, what I am about to tell you as a potential functional medicine patient in our clinic is critical toward helping you finally get some answers for say, your thyroid condition, blood sugar condition, weight gain or loss, digestive complaints or your hormonal imbalance.
PATHOLOGICAL VS. FUNCTIONAL
Now you may not have known, but there are actually two main types of ranges in the field of blood chemistry analysis that can be used to evaluate your lab tests and those are pathological ranges and functional ranges. And understanding the difference between these two is your first step toward finding a solution to your symptoms.
So, what does this all mean to you? First, when we use the word “range” what we are talking about are the high and low values of a particular biomarker found on a blood test, such as TSH, or thyroid stimulating hormone for example, that represents the upper and lower limits of what is considered normal.
THE BIG DIFFERENCE
The main difference then, between the pathological range and the functional range is the degree of deviation allowed within each of their “normal” ranges. In other words, the upper and lower limits for pathological ranges are usually a lot greater and broader than the more narrow, or healthy, functional ranges.
The reference ranges provided to you in the past for which your lab tests were compared have more than likely been these broad pathological ranges. And so you would have needed to have lost a significant level of health to fall outside the “normal range” and into the pathological range in order to be diagnosed with a disease or to have been told you have a high risk for developing a particular disease.
Otherwise, if you were anywhere near the upper or lower limits of this broad pathological range, but not outside of these upper and lower limits, then you were likely considered “normal”.
So the traditional approach to health care that many of us are exposed to, as far as blood chemistry analysis is concerned, is based strictly on these broad pathological ranges where a person is either considered diseased, or considered healthy, and it rarely takes into account the early detection and prevention of a particular disease or the early decline in one’s health.
THE ROLE OF FUNCTIONAL MEDICINE
This is where functional medicine comes in. Functional medicine practitioners consider anything outside the functional health ranges (not pathological lab ranges) as a risk for disease. Therefore, we do not analyze your blood test results based upon these broad pathological ranges simply because there is no discrete moment in time where you are healthy one day and diseased the next, unless of course trauma was involved.
Instead, people tend to lose their health gradually, over time, until it’s almost too late to do anything about it. And so the functional medicine practitioner is one who is focused on the following:
- early detection of disease,
- early prevention of disease,
- the management of the symptoms for those who are already diseased.
Again, this is why functional medicine practitioners use the more narrow functional healthy ranges to analyze your blood tests. Anything outside of them is considered at risk for the development of disease and certainly anything already outside the broad pathological ranges must be managed appropriately.
WHAT DOES IS MEAN TO BE HEALTHY?
These narrow functional ranges are designed around what constitutes good health and that not only means just being disease free, but also:
- having adequate energy,
- healthy digestion,
- ideal physiological function,
- a sharp mental focus, and
- a positive outlook on life.
So if certain biomarkers (triglycerides, cholesterol, LDL, etc.) start to fall outside of their functional ranges, but yet are still within their pathological ranges, you are likely to start expressing symptoms of a particular disease long before you are actually diagnosed with it.
YOU ARE SHARING COMPANY WITH MILLIONS OF OTHERS
This is what happens to millions of people who have lab tests run where their biomarkers, such as TSH, liver enzymes, etc. fall outside the healthy functional range where good health is experienced but are still within pathological range where disease is not yet present.
These are the people who are not healthy and know it and express disease related symptoms, but yet their lab tests keep coming back as “normal”.
EXAMPLE: THYROID STIMULATING HORMONE (TSH)
Let’s take the biomarker TSH for example. The pathological range is typically between 0.5 and 4.5 uIL/ml. But the functional range where optimum health is enjoyed, is much more narrow being between 1.8-3.0.
So now the question for you is this: what if your TSH is found to be 3.9? What does this mean? Well, for one, you won’t be diagnosed with a thyroid condition, because you are within the pathological ranges.
And chances are you will be told your thyroid is healthy and your labs are essentially normal. And again, this is because you are within the pathological range provided by the lab whose upper limit is 4.5.
However, even though you are within the normal pathological ranges, you are still outside of the upper limit of 3.0 on the functional range. So, you are likely to experience many of the same symptoms as if you did already have an under-active thyroid gland.
You might have the following symptoms:
- tired and sluggish,
- chronic fatigue,
- have cold hands and feet,
- possible gain weight
- come down with depression
- the outer thirds of your eyebrows may start to thin and
- your skin may become dry.
So, a person with a TSH of 3.9 in our office will be viewed as someone who should be experiencing symptoms of an under-active thyroid gland and as someone who is starting to lose some level of their health.
The same goes for any other lab marker that falls just outside of the functional range such as total protein, liver enzymes, serum iron, etc. Their labs won’t be considered “normal” in our office.
And again, this is because people don’t tend to lose their health all at once, but rather gradually over time and these functional ranges are geared toward finding the slightest imbalances in the body’s metabolism long before diseases manifest.
FUNCTIONAL MEDICINE PRACTITIONERS USE FUNCTIONAL LAB RANGES
So as a functional medicine practitioner, your blood tests will always be evaluated based on functional ranges wherever appropriate and not pathological ranges. This allows us to provide you, the patient, with sound recommendations, screen for health issues, and monitor changes for treatment much more accurately.
This also puts you, the patient, in a much better position to be proactive in your healthcare long before a serious problem develops. By making the necessary diet, nutrition and lifestyle changes sooner rather than later, you can begin to restore your body’s ideal physiology and start living again as a truly healthy individual.