What does “normal” bloodwork really mean?

Almost every day, I see a patient who’s exhausted despite getting enough sleep, struggling with brain fog, and gaining weight around her middle without eating differently. She’s had bloodwork and been told everything is “normal.”

What I explain is that normal and optimal aren’t necessarily the same.

• “Normal” means a result falls within the lab’s reference range.
• By “optimal,” I mean a level that supports that person’s health and function, taking into account her unique symptoms and medical history.
• There isn’t one perfect number for everyone, and being within range doesn’t automatically mean all is well.

I also look at what hasn’t been measured. Vitamin B12, vitamin D, omega-3 and omega-6 fatty acids, fasting insulin, and free T3 (the active unbound form of thyroid hormone) levels are some of the most frequent ones I see missing from routine bloodwork.

So here are two things I always look for:

1. Have all the labs that may explain how she is feeling been done?
2. Are the results in the optimal range for her?

If she’s still experiencing symptoms, “your labs are normal” shouldn’t be the end of the conversation. Consult with a functional medicine or longevity practitioner who understands the difference between “normal” and optimal and can help you feel better, and you can learn more in my upcoming book, too.

—Frank Lipman, M.D.

+Testing, testing

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• Thyroid labs say “normal,” but you don’t feel that way