*This blog is not intended to diagnose or treat and disease or disorder. Please consult your healthcare practitioner before making any health changes.
So your bloodwork all came back within normal range but you don’t feel normal – what does this mean?
This doesn’t mean that your symptoms aren’t real! Keep reading to know why labwork isn’t always perfect and the top 5 blood work red flags to look for.
Problems with labwork
1. Your doctor isn’t running a comprehensive blood work panel
Many doctors will not run a comprehensive set of labs for people who are considered healthy. Instead of taking a preventative approach, bloodwork is often only used to diagnose or manage the treatment of diseases. Without a diagnosis, getting adequate bloodwork done without explicitly asking for it can be difficult.
Furthermore, some standard labwork is not always covered by insurance. For example, it’s estimated that over half of New Englanders are Vitamin D deficient, yet the test is not always covered by insurance.
Here is the minimum bloodwork I recommend requesting each year:
- Complete Blood Count with Differential
- Metabolic Panel
- Lipid Panel (Total Cholesterol, HDL, LDL and Triglycerides)
- Vitamin D
Helpful Add-ons:
- Iron
- Ferritin
- Vitamin D
- B12
- Thyroid Panel: TSH, Free T4, Free T3, Thyroid Antibodies
- CRP
- HbA1c
2. Standard reference Ranges aren’t always “optimal Ranges”
Reference Ranges are based on “groups of healthy people”. This is pretty vague! In the medical field, out-of-range labs can also be used to diagnose diseases. However, in my practice, I aim to help people feel awesome, not just without a disease. By looking more closely within the range of each lab marker, we can look at the optimal ranges of each marker. This will help determine suboptimal nutrient status, organs that need more support, and many other indicators of the health of the body.
3. Each marker is looked at on its own
Looking at patterns across different markers reveals much more information than stand-alone markers. For example looking at the patterns of Sodium, Potassium, and Cholride can indicate chronic stress levels that wouldn’t be clear by looking at each marker individually.
4. You aren’t looking at bloodwork trends over time
I’ve had many clients tell me that after they were diagnosed with a disease, they looked back at their labwork and saw markers related to their diseases slowly rising over the years. For some, diseases could have been prevented or interventions could have been implemented earlier if trends were being followed. I recommend working with someone who looks at your labwork, looks at trends, and helps you understand what trends to watch in the future.
Top 5 Common Blood Work Imbalances
1. MCV (Mean corpuscular Volume)
MCV tells us the average size of your red blood cells. Size varies based on nutrients like B12 and iron.
Optimal Range: 80-90 fl
Low MCV: This can indicate low iron status. Check hemoglobin, hematocrit, iron, and ferritin levels to confirm. Also, check B12 levels to rule out simultaneous iron and B12 deficiencies.
High MCV: May indicate suboptimal B12 levels.
Both high and low MCV values are common among vegans, vegetarians, and those with poor digestion related to gut health issues.
2. Triglycerides (fasting)
Triglycerides are a marker of free fats in the blood. We make triglycerides in the liver and get triglycerides by converting them from carbohydrates in food. The conversion primarily happens when there is a high amount high amount of sugar in the blood following a meal.
Optimal Range: 50-100 mg/dL
Low Triglycerides: Much less common, low triglycerides can be related to hyperthyroidism, autoimmune diseases, liver or biliary duct obstructions or falsely lowered by vitamin C supplementation.
High Triglycerides: High levels (especially when fasting) often indicate high consumption of refined carbohydrates (sugar) and possible blood sugar dysregulation. Check fasting glucose, HbA1c, and fasting insulin to assess blood sugar status. High triglycerides can also be related to hypothyroidism.
3. Creatinine
Creatinine is a byproduct of muscle breakdown when muscles contract. The kidneys filter creatine out of the body.
Optimal Range: 0.8-1.1 mg/dL
Low Creatinine: Associated with low muscle status or low exercise. Low creatinine can also be associated with low protein intake, especially low animal protein intake.
High Creatinine: Associated with dehydration, excessive protein breakdown/muscle atrophy, UTI’s or urinary tract inflammation, uncontrolled Diabetes or kidney function.
4. Fasting Blood Glucose/Sugar
Optimal Range: 80-100 mg/dL
Low Blood Glucose: For people who are not diabetic, low fasting blood sugar may be related to overall low intake of food.
High Blood Glucose: High blood glucose is associated with eating too many carbohydrates or not eating enough protein and fats. Chronically high blood glucose may indicate some degree of insulin resistance which over time can lead to Pre-Diabetes and Type 2 Diabetes. Check triglycerides, HbA1c, and fasting insulin to confirm. Glucose can also rise under stress.
5. Vitamin D
Vitamin D, which is actually a hormone, is made from the sun hitting the skin and then getting processed in the liver. When the sun is less strong, like in the winter in New England, the sun is not strong enough to make us produce vitamin D. Most foods are not a good source of vitamin D, however, fortified foods, fish and liver has some vitamin D.
Optimal Range: 50-80 ng/dL
Low Vitamin D: Low vitamin D is associated with frequent illness, worse COVID outcomes, autoimmune disease, poor bone health, leaky gut, and much more. Even among holistic practitioners there is a debate about the optimal vitamin D levels, but all adults should have a vitamin D of at least 50.
High Vitamin D: High vitamin D may be associated with over-supplementation of vitamin D
What to do now?
- Access the most recent labwork you have
- Download my labwork monitoring guide by clicking here
- Continue to monitor labwork each year!
Don’t have a PCP who will run labwork for you? You can order a comprehensive labwork panel from me here.
** Testing is not available in NY, NJ, RI, or outside of the continental United States.
