What to Do When Blood Tests are Abnormal
The art and the science of medicine converge in interpreting lab results with the hope of giving patients answers to their health questions. For some, the question is simply, “Am I well?”. For others, the questions may include, “Why do I hurt?” or “Why am I tired?” and a million other sought after answers for symptoms. At first blush, you might think that having more tests will always give better answers, but here the art of medicine better directs the ordering of tests when we consider the science behind the medical tests.
With many do-it-yourself opportunities for ordering your own lab tests running their ads and promising a healthier you, why not? Surely, having more tests will shine a light in that one hidden area of your body that will either explain why you have some symptom or could catch something years before it ever becomes a real problem. If it were only that simple, we probably would not need medical school or health professionals.
Don’t get me wrong, we want our patients to understand as much as they can about their health. We want to educate and empower them 100% of the time. However, just giving them the tests is like handing a 16-year-old car keys and telling him to get on the highway for his first ever time in the driver’s seat.
For that reason, I take a moment here to explain why you should not automatically go on high alert when you get an abnormal lab result, whether you or your medical provider ordered the lab. Abnormal tests have a few different reasons to be not worth worrying about. Some other time, we can discuss why you should not always be reassured by so-called normal tests, though perhaps the details below will give you a clue.
First, for many tests, lab companies evaluate normal versus abnormal based on reference ranges. The lower limit is set at a point where 2.5% of people are below that result and the upper limit is set at a point where 2.5% of people tested are above that number. This may or may not have much relationship to whether your result is good or bad. Sometimes you can be 1 or 2 points below or above the reference range and still be perfectly normal, while that small deviation could be indicative of a serious problem other times. You need someone with experience to help you know the difference. Don’t lose sleep until you get trusted guidance.
Second, our bodies’ metabolism is a dynamic process rather than a static measurement. For some labs, the time of day may cause fluctuations in the levels, such as with hormones. For others, your last meal can drive numbers up and down. Sometimes, even taking a Tylenol could alter the result. Often numbers just fluctuate between so-called normal and mildly abnormal without causing you any problems at all. When we see these mildly abnormal labs on metrics that are known to fluctuate, we usually retest both to be sure it is a real problem AND to see if the number is getting worse. Again, don’t lose sleep until you talk to someone you trust.
Third, without going into the weeds of the statistics and calculations, if you do enough tests at once, you will likely get at least one abnormal. Many say that 20 lab results almost guarantee at least one mildly abnormal number. So, if you go online and get 100 or more tests from the DIY option, they will have something to warn you about. Whether it is a real problem or not is unclear in many cases. Yes, I will say it again: don’t lose sleep over these numbers.
Many of our patients come with a long list of so-called normal labs but know that something is wrong because they feel terrible. That situation is different in one sense, but just like this issue of having abnormal labs, you need someone you can trust to tell you whether a problem exists and what that problem is.
Regardless, the art of medicine requires sitting down with patients, understanding their symptoms, their lifestyles, their family histories, and even their health goals if we are to correctly guide them in interpreting lab results. With that approach we can help our patients know when to rest assured, when to do more testing, or when to seek therapy. That is what helping others strive after a healthier, more abundant life looks like.
Sanctuary Functional Medicine, under the direction of Dr Eric Potter, IFMCP MD, provides functional medicine services to Nashville, Middle Tennessee and beyond. We frequently treat patients from Kentucky, Alabama, Mississippi, Georgia, Ohio, Indiana, and more... offering the hope of healthier more abundant lives to those with chronic illness.
Dr. Eric Potter graduated from Vanderbilt Medical School and then went on to specialize in internal medicine (adult) and pediatric care, spending significant time and effort in growing his medical understanding while caring for patients from all walks of life.
