Why being “fine” isn’t good enough
Lab results may not flag a problem, however the numbers can reveal a lot about your health, and can mean the difference between feeling fine, and feeling optimally healthy.
Whenever I see a new patient, I always recommend they bring in a copy of their most updated bloodwork, or, if it has been a while, I might suggest they get new bloodwork done.
Why do I insist on actually seeing a copy, instead of accepting “My Doctor tested everything, and it was all fine”? Well, 2 main reasons.
Often “testing everything” doesn’t mean quite that. There might be something useful that was missed, or a result that might suggest further testing is warranted. As a Naturopathic Doctor, we have access to certain tests, that your Family Doctor may not.
The most important reason is that Naturopathic Doctors (NDs) bring a different perspective to your bloodwork. NDs are focused on optimal health and wellness. It is obviously critical that we rule out any kind of disease, or pathology, which might present as abnormal lab values. But what about those people who feel unwell, but fall within the broad “fine” ranges on their bloodwork? Anybody who knows me, knows that I can’t stand the word “fine” – to me it means, not great, but passable. I don’t think anyone should have to accept a diagnosis of “fine”.
To make the leap from fine to optimal, it is often necessary to aim for a narrower range on blood tests. Every individual will have different needs, but there are some general recommendations based on where most people feel their best.
The examples below are common cases I see in my practice:
FERRITIN
Lab range: 15-247 pmol/L
Ideal range (women): 70-100 pmol/L
Ideal range (men): 80-150 pmol/L
Ferritin is your body’s storage form of iron and important for so many functions including energy production, physical and mental stamina, mood, skin and hair health, and metabolic function.
This is the biggest culprit of “I was told everything on my bloodwork was fine”. I have seen so many blood tests with ferritin values in the low teens, and the patient never realizing that might not be ideal, or not even being told to increase iron intake through diet or supplements.
I consistently see fatigue, hair loss, acne and brain fog alleviated by increasing iron intake, and subsequent ferritin levels.
Keep in mind, that too much iron can also be harmful so take caution in supplementing, and make sure you test your levels before supplementing. Very high ferritin levels can also signal systemic inflammation in the body, so an iron panel may be beneficial in these cases if your ferritin levels are very high.
VITAMIN B12
Lab range: 153-655 pmol/L
Ideal Range: 500-600 + pmol/L
Vitamin B12 is critical for energy production, brain health and the function of your nervous system, as well as the repair of your DNA. I find many people are low (but still within range) in this important vitamin. Supplementing helps to improve energy, boost mood and decrease anxiety.
Some individuals are not able to absorb vitamin B12 from food or supplements, so in those cases B12 injections with your Naturopathic Doctor would be necessary.
VITAMIN D
Lab range: 75-150 nmol/L
Optimal range: 90-120 nmol/L
Vitamin D is no longer routinely tested, as it is assumed most Canadians are deficient. A combination of decreased sun exposure, and slathering of sunscreen decreases our conversion of sunlight to Vitamin D in our body. I recommend getting your Vitamin D tested, as it will help to determine your ideal level of supplementation. In Canada, this is a test you will likely have to pay for, but it’s well worth it since Vitamin D is needed to regulate over 900 genes in our body. It is also critical for hormone production, as well as bone and immune health.
THYROID
TSH
Lab range: 0.32-5.04 mU/L
Ideal range: 1-2 mU/L
Often times, TSH is the only blood test done to rule out any thyroid conditions. TSH, which stands for thyroid stimulating hormone, is released from the pituitary gland in response to the levels of thyroid hormone in the body. If there are a high number of circulating thyroid hormones, then the pituitary secretes less TSH to help bring thyroid hormone levels in balance. The opposite is true when thyroid hormones are low, the value for TSH will increase, to get the body to increase more thyroid hormones. So in short, a higher TSH means your thyroid is not producing enough thyroid hormone.
If I suspect thyroid issues, or TSH is outside the ideal range, I recommend testing thyroid hormones (T4 and T3) in addition to TSH, as this will give us a much more concrete idea of thyroid health. Read here for more detailed information on thyroid health and testing.
Free T4
Lab range: 10.6-19.7 pmol/L
Ideal range: 14-19 pmol/L
Free T3
Lab range: 3.0 – 5.9 pmol/L
Ideal range: 4.9 – 5.9 mU/L
Please contact me if you have any questions, or would like to schedule an appointment to discuss getting you to an optimal state of health.