The Rebel Podcast

Ep. 59 – When Your Doctor Says Your Labs are “Normal” (But You Still Feel Sick) – with Jennifer Savage

Jennifer Savage holds a doctorate in the field of Traditional Naturopathy and promotes client-centered health strategies with a focus on cellular function. She also works as a Functional Medicine Consultant teaching doctors, holistic practitioners, and health coaches the concepts, methods, and principles of functional medicine application within their practice.

As a Functional Health Practitioner, Jennifer utilizes functional lab testing to understand her client’s current state of dysfunction and to then present healing opportunities for her clients – and today, she’s going to explain what some of the functional labs available to you are and what they can tell you about your health.

Because sometimes you go to the doctor and you know something isn’t right, but they tell you that your pathological/conventional labs are “normal” and nothing is wrong – and you should always feel empowered to advocate for your own health, and functional medicine practitioners like Jennifer can help you do that.

Before we get into it, though, I want to note that lab work is always a single set of information from a single point in time. It’s never going to give us a complete picture of everything that’s happening in the body. It’s just a few clues.

Two Viewpoints

Conventional medicine uses lab testing for diagnosis and disease. Functional medicine, on the other hand, uses lab testing to view areas of imbalance that can be supported.

For example, what is the difference between a Functional Blood Chemistry Analysis and a Pathological Blood Analysis (“regular” blood test)? The pathological range is used to diagnose disease. The functional range is used to assess risk for disease before the disease develops.

That seems pretty good, so why don’t most health care providers embrace the functional range?

A lot of health care providers think that care should be provided when disease is present. This view is generally formed from conventional medical training, which often ignores the philosophies of preventative medicine and nutrition.

So let’s talk about one of the most common and powerful functional medicine labs: blood chemistry testing.

Blood chemistry testing measures chemicals including enzymes, electrolytes, fats (also called lipids), hormones, sugars, proteins, vitamins and minerals, and these values are recorded as levels in the body

Now, let’s dig in a little deeper.

What are reference ranges?

Standard blood work shows values of tested elements in our bodies that fit within a reference range, and each lab that analyzes blood work has their own range

Where do they get their ranges?

The reference ranges are calculated so that they encompass 95% of apparently healthy people.

However, a greater amount of sick people need to have blood drawn than healthy people, so that skews the ranges a little bit. Not only that, sick people may get blood tests done and receive results that are normal, thus determining that sick person to be “healthy” and adding their data to the 95% of apparently healthy people.

That’s part of the reason why functional medicine practitioners look for an optimum range for a specific individual, not an average of all individuals.

So a functional range is not for diagnosing disease – it’s for optimizing health.

Why should we consider getting a blood test done?

To empower yourself!

You don’t have to just go see a doctor when you’re feeling sick. You can go to make sure you stay healthy, and further optimize your health so that you feel even better

What services are available to request your own blood testing?

Where can you learn more about evaluating your blood chemistry markers?

Tips for blood draw/testing

  • Try to plan your blood draws at the same time of day each time you test for consistent trends
  • Fasting may be needed for things such as glucose or cholesterol panels
  • Stop supplements at least a few days before the test or you may end up testing the supplement

Free download – List of functional ranges sheet

You can use this form to enter in your own blood chemistry values and track trends over time.

Click here to download the form.

Here are 6 common labs that can provide a lot of insight (and their associated target ranges):

1. Vitamin D

Conventional range: 20.00 – 100.00 ng/ml

Optimal range: 50-100 ng/ml

The following Vitamin D levels are associated with the following health benefits:

  • 20 – Institute of Medicine- bone only beneficial
  • 22 – where colon cancer begins to decline
  • 32 – where breast cancer begins to decline
  • 34 – colon cancer rates would be cut in half
  • 40 – where most reach max bone density
  • 52 – where breast cancer rates would likely to be cut in half
  • 60 – autoimmune patients begin to improve
  • >150 – toxicity

2. Thyroid

Unfortunately, most MD’s just check TSH. But this is an indirect, inadequate marker for thyroid status. To truly assess thyroid function, you must have your Free T3, Free T4 and Reverse T3 checked.


Conventional range: 0.400 – 4.500 mU/L (milliunits per liter)

Optimal range: 1.30 – 3.0 mU/L (milliunits per liter)

Free T3*

Conventional range: 2.3 – 4.2 pg/ml

Optimal range: 3.0 – 3.50 pg/ml

*Low Free T3 will present as FATIGUE!

Free T4*

Conventional range: 0.80 – 1.80 ng/dl (Nanograms Per Deciliter)

Optimal range: 1.00 – 1.50 ng/dl

*Often times, I see normal Free T4 and low Free T3. This is indicative of hypothyroidism, but of course we have to ask WHY? Normal T4 and low T3 indicate there is likely an underlying adrenal issue. Cortisol, the stress hormone produced by the adrenal glands, inhibits the conversion of T4 to T3 (thus resulting in low Free T3 and then fatigue).

Reverse T3*

Conventional range:  8.0 – 25.00 ng/dl (Nanograms Per Deciliter)

Optimal range: 10 – 25.00 ng/dl

*Elevated Reverse T3 is indicative of stress or adrenal dysfunction.

3. Vitamin B12

There are several markers of B12 status. A serum B12 can provide a rough estimate of B12 status, but there are many other indicators of B12 status:

Vitamin B12 (serum)*

Conventional range: 200 – 1100 pg/ml

Optimal range: 450 – 800 pg/ml

*It is well-established in the literature that people with B12 levels between 200-350 have distinct

B12 deficiency symptoms:

  • Alzheimer’s, dementia or memory loss
  • Depression, anxiety, bipolar, psychosis
  • Fatigue
  • Numbness or tingling
  • Nerve pain

Methylmalonic acid (MMA) – this is a very sensitive test and will reveal a true B12 deficiency if high. If your serum B12 was “normal” but you still have signs of B12 deficiency, ask your doctor to order the MMA test

MCV (Mean Corpuscular Volume)

MCV is a measure of the average volume of your red blood cells. When MCV is high, this is indicative of B12 or folate deficiency. When MCV is low, this is indicative of Iron deficiency. This is part of a routine CBC test.

Conventional range: 80 – 100 fL (femtoliters)

Optimal range: 82 – 89.9 fL (femtoliters)

4. Cholesterol- VAP test

Total Cholesterol

There is a happy medium with cholesterol levels. You don’t want your levels too high, but you also don’t want your levels too low. Low cholesterol (less than 150) can result in memory loss, anxiety and depression.

Conventional range:  125.00 – 200.00 Mg/dL (milligrams per deciliter)

Optimal range: 160.00 – 180.00 Mg/dL (milligrams per deciliter)

Simply looking at total cholesterol is inadequate. We must take into account your lipid particle size, LDL, HDL, lipoprotein a, and other markers. A comprehensive cholesterol test that will include these markers, such as particle size, etc. is the VAP test.

5. Blood sugar

Like cholesterol, there is also a happy medium with blood sugar. Elevated blood sugar can cause a whole host of symptoms/conditions- weight loss resistance, obesity, diabetes, heart disease. Low blood sugar, or hypoglycemia, can also be problematic, causing irritability, anxiety, palpitations, fatigue, headache and hunger.

Fasting blood sugar (Glucose)

Conventional range: 65.00 – 99.00 mg/dL

Optimal range:  75.00 – 86.00 mg/dL

Hemoglobin A1C

This is an average of blood sugar control over 3 months.

Conventional range:  0.00 – 5.70 %

Optimal range:  4.60 – 5.50 %

Fasting Insulin

Insulin regulates blood sugar. High blood sugar stimulates the release of insulin, whereas low blood sugar levels prevents insulin release. The most common abnormality with insulin is insulin resistance, in which the cells no longer respond to insulin. Elevated insulin increases your risk of diabetes, high cholesterol, breast cancer, PCOS, obesity, hypertension, and heart disease.  Insulin is a storage hormone, primarily promoting fat storage.

Conventional range:   2.00 – 19.00

Optimal range: 2.00 – 5.00

6. Ferritin

In addition to assessing one’s serum iron status, red blood cell status, hemoglobin, and hematocrit (as part of a routine CBC), I always check ferritin if I suspect iron deficiency anemia. Iron deficiency anemia is a common problem among women and children.

Signs of Iron deficiency anemia include:

  • Fatigue
  • Pale skin
  • Weakness
  • Irritability
  • Brittle nails
  • Dizziness
  • Leg pain
  • Restless legs
  • Headaches
  • Poor memory

Ferritin is the storage form of iron. It is low with iron deficiency anemia, which is common among menstruating women. Ladies, if you are tired, ask your doctor to order ferritin!

There is a happy medium with iron though. Iron in excess is inflammatory and can be an underlying cause of chronic disease.

Conventional range:  10.00 – 232.00 ng/mL

Optimal range:  30.00 -70.00 ng/mL

Download this Episode MP3.


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