- Today, we're going to talk about laboratory reference range and it sounds boring, but it's really important. See, doctors typically interpret tests as normal or abnormal. Now, let's talk about what normal means.
It means that 95 or so percent of the population falls into that range. It doesn't matter if you're sick or not, young or old, two or 92. Well, there are some adjustments for kids, actually, but normal is just a statistical number which means that you fall into two standard deviations from the mean.
That means, on either end, there are only a couple of percent of people who are high or low. Now, that doesn't mean it's normal in the way we think of it or optimal. It's just a statistical number.
In fact, health and disease occur along a continuum from super healthy to super sick. And these tests need to be interpreted according to what is best for a healthy human. For example, vitamin D levels are considered normal if they're over 20, but the ideal is over 50.
Why is it 20? 'Cause 80% of the population is vitamin D deficient, so they fall into that range. It doesn't mean that 20 is the best number for your health.
For example, blood sugar number that's normal is under 100, but we know that optimal is 70 to 80. Anything over 80, you start to get increasing risk. It's just the fact that we're a sick population.
Also, if you were to be a martian and you landed in the United States, it would be quote normal to be overweight because 70% of our population is overweight. Even the skinny ones have metabolic issues. 25% of the skinny people are what we call skinny fat and they're not healthy even though their weight is normal.
So the normal weight in America is fat. And that's not what we want to aspire to. We want to aspire to health.
So, with that understanding, let's jump right into some basic medical measurements that are so simple but can tell us a lot about our health and our constitution. And they're often overlooked. Let's just spend one more minute on normal.
Often, you go to the doctor and you're told your tests are all quite normal. But you still don't feel good. So what does that mean?
It doesn't mean you're not sick. It doesn't mean you're thriving. And it means, like I said before, one of two things.
Either your doctor's missing something or you're crazy and I'm betting your doctor's missing something. Now, this is one of the main differences between functional medicine and conventional medicine. In functional medicine, we're not playing the game of sick care, we're aiming for optimal health.
We're looking for more subtle deviations from optimal. When most tests are quote abnormal, for example, your kidney function, you've lost half your kidney function. By the time your liver function's abnormal, your liver cells are dying.
That's a little late. A functional medicine doctor may review the results you get from the same lab tests much differently than a conventional doctor. This is because the ranges that we're aiming for are more specific to optimal health, not disease.
Now, most conventional doctors are not trained to analyze labs from the perspective of health. And they may either take a watch and wait approach, which can be quite dangerous, or they will order the minimum testing required to label you as not sick. In fact, one patient came in with a blood sugar of 120.
Now, 126 is type two diabetes, and I said, "Did you see your doctor about this? " And he said, "Yeah. " I asked him what did the doctor say and he said "Well, he said wait until "I actually had diabetes and then come back for medication.
" That is the last thing we want to be doing. In medicine, we use things called reference ranges. These give us a range of values that have been seen in the normal population and normal is relative.
It changes based on age, gender, physical activity and so much more. In fact, if you were to assess someone's weight in America today, it would be normal to be overweight as I said, because 70% of us are overweight. We keep changing the reference ranges based on a sick population.
This is not what we should aspire to. This is why functional medicine treats the individual, not just the numbers. In addition, what's considered normal ranges by the labs change over time.
You know, one fascinating example of how these ranges change is seen in a recent change made by a known global lab company called LabCorp. Now, they recently changed their reference ranges for male testosterone levels. Previously, LabCorp considered the normal range of testosterone for an adult to be 348 to 1197.
Now, this value was based on a population of lean, adult males. However, in 2017, they lowered the bottom end of that range from 348 to 264 and the higher range down to 916. This means that overweight men, but not the obese men, were likely included in this cohort, which led to the reduction of what is considered a normal testosterone level.
It's known that excess abdominal fat leads to lower testosterone levels and by changing these reference values, conventional medicine is now considering overweight individuals as the norm. That is not what we want. We want to be healthy, not just a little fat.
So let's pause for a second. This is really mindblowing. This is the exact reason you need to take control of your own health and as society gets sicker and now one in two people have a chronic disease, we have to rethink how we interpret labs and that normal may really not be normal, just average, for a sick population.
