HOW TO AVOID COMMON PITFALLS IN BLOOD CHEMISTRY INTERPRETATION

You’ve been struggling with your health for god knows how long so you go to the doctor and have them run a blood test, or perhaps you run one yourself. The numbers on the report, whatever they show, will surely offer a reassuring sense of certainty amidst the confusion and overwhelm of shifting subjective symptoms and undulating moods.

Even if we don’t know exactly what they’re telling us, at least there’s something tangible, objective, certain we can point to to indicate our current status.

This is really the allure that brings us to blood chemistry: our fundamental need for certainty as a way to quell the uncomfortable feelings and anxiety of “not knowing” that comes from noticing and observing.

But this “certainty” is a false promise. Blood chemistry interpretation is based on layers of misunderstanding of what these values mean.

At the level of Industrial medicine, the reference ranges are based on invalid applications of statistics, archaic misunderstandings and politics. I know that’s bleak, but that’s really what it comes down to.

Functional medicine and Integrative medicine has tried to improve on this - these areas of study tend to look at more markers and use altered reference ranges.

But aside from the problem of lack of standardization (10 practitioners will tell you 10 different things about what your results mean), it also comes from the misunderstanding that your chemistry causes you to have a certain level of health rather than your chemistry is a certain way because of your current levels of health.

There are of course examples we can point to where microscopic things cause problems: arsenic poisoning will “cause” you to be get sick if not dead, no doubt. Bottom up causation, something microscopic causing an effect at the human level certainly exists. It’s just the exception.

But I’ve run and analyzed hundreds of panels. I constantly meditate on the relationship between these numbers and the person I see in front of me. Outside of extreme cases of acute poisoning, serious illness, or genetic abnormalities, our blood chemistry shows us a reflection of how we feel, not a cause of how we feel.

It’s not to say that metabolic blood panels don’t have any value. They’re a tool and when used well can help support our progress. They can help us rule out serious problems and can help us track progress.

But we need to keep some things in mind:

• When you decide to run a lab test, make sure you have a specific question in mind that you’re trying to answer. More information is not better!
• Interpretation, interpretation, interpretation. An improperly interpreted blood panel is worse than no panel.
• Metabolic panels are unlikely to provide information to get us unstuck or help us with a plateau. For this, we need to follow a process. Test, assess, feedback, iterate.