Getting back lab results from your medical provider with everything marked as “normal” can provide a sense of relief. But what if you’re still feeling fatigued, foggy, or other “off” symptoms you can’t quite explain? Or you go back to the doctor months or years later only to be diagnosed with a condition that’s seemingly come out of nowhere?
For many, this disconnect can be frustrating and confusing — and a result of how we define “normal,” says Jim LaValle, RPh, CCN, chief science officer for Life Time. “‘Normal’ doesn’t always mean ‘ideal for you,’” he says. “We instead are looking to answer the question, ‘How far are you from your best health?’
Instead of relying solely on “normal” ranges, Lavalle believes the key to feeling better lies in understanding both your symptoms and how your lab ranges are trending over time. This, he maintains, can help you understand your future risk profile for conditions or diseases.
What is the difference between “normal” and “optimal” lab results?
In traditional lab systems and medical settings, “normal” ranges are derived from large populations and represent the spread of results expected in about 95 percent of people. “This means you can be in the ‘normal’ range and still not be functioning at your best,” says LaValle. “This information can be useful for diagnosing a clear disease, but it has limitations.”
A reference range, Lavalle continues, can’t always predict if you are trending in the wrong direction or explain why you’re experiencing unexplainable symptoms. “More importantly, it can’t determine the steps you specifically need to take to change your health trajectory.”
“Optimal” ranges, on the other hand, aim for the zone where the human body tends to run its best with the lowest risk of long-term breakdown, Lavalle says. It is where your body can perform at its best.
This matters because most chronic health issues don’t begin suddenly, according to LaValle. “Bigger issues often start out as trends, with lab values drifting higher or lower over time, often while someone still feels ‘off,’ even though their labs might technically be in the normal range. The earlier you catch a negative trend, the easier it is to take action and correct it,” he says.
“Diagnostic ranges are critical for ruling a disease in or out,” LaValle continues. “However, it’s important to overlay those numbers with tighter, evidence-informed optimal ranges that reflect what is seen in metabolically healthy, high-functioning individuals.”
Can values within a normal range still be a sign of long-term disease risk?
Yes, LaValle says, pointing to this as one of the most important concepts to understand when it comes to precision and personalized medicine.
In a traditional setting, labs are often ordered to determine if you have a diagnosable disease. If you don’t, you might be told everything looks fine — even if your numbers are slowly drifting in the wrong direction and you’re not feeling your best.
“If a value is normal but near the high end or low end, or if it’s steadily trending worse, you can be watching the early stages of various issues, including insulin resistance, inflammatory markers rising, nutrient depletion, thyroid slowdown, gut health issues, liver or kidney strain, and growing cardiometabolic risk,” LaValle explains. “The point is, we can use both normal and optimal ranges to signal us to take action to prevent poor trends from eventually becoming a diagnosis that’s then much harder to tackle.
“For example,” he adds, “our treatment model at MIORA uses a broad range of blood markers that shows us how well key systems in the body are functioning and operating together. Our body works as a system of systems, and when one system weakens, it can impact others. We gather data and interpret it through the lens of optimal ranges, patterns between organs and systems over time, and how it fits into the bigger picture of your health, rather than waiting for a single number to cross a disease threshold. That is how we identify metabolic roadblocks early to improve resiliency and metabolic capacity.”
These are some common issues with lab values that LaValle sees in practice:
- Blood sugar and insulin: “Many people focus only on fasting glucose levels, but someone can have a glucose in the normal range and still be developing insulin resistance,” says LaValle. “When we see high normal fasting glucose alongside elevated insulin, higher inflammatory markers, or changes in your lipids, it can clearly signal that you’re heading toward insulin resistance or diabetes long before it appears on a standard report. A 10-year study on almost 47,000 people showed that for fasting glucose, every point above 84 mg/dL represented [an incremental] 6 percent risk of developing diabetes over the next decade. In other words, even though a 96 mg/dL glucose reading is in the normal range, it represents a 66 percent increased risk of developing diabetes in the future.”
- Thyroid patterns: “A person can have ‘normal’ TSH (thyroid-stimulating hormone) levels but still feel tired, cold, constipated, or foggy, or struggle with their weight,” he says. “Looking at the whole thyroid picture, not just one marker, often explains symptoms earlier than a single number does.”
- Vitamin D: “Vitamin D levels can be ‘normal’ but still too low for optimal performance and resilience,” LaValle says. “If a value is in normal range but on the low side and trending down, you may be setting yourself up for metabolic and immune issues — and that’s a time to take corrective steps and then retest.”
Your Symptoms Are Real Data
Lab work can give you valuable, tangible information about your health, but LaValle emphasizes the importance of paying attention to your symptoms as well. “A lab value is only one part of the story, albeit an important one,” he says.
If you’re feeling frustrated with the lack of information around your results from your medical provider, LaValle recommends trusting your own experience and advocating for yourself. “If you’re exhausted, gaining unexplained weight, not recovering from your workouts, or your mood and sleep are off, those are real concerns — whether a basic blood panel flags it or not.”
LaValle recommends the following strategies when evaluating your lab ranges and symptoms:
- Ask for exact numbers. Learn specifically what value your lab results show, not just whether they’re “normal” or not. You often need more information than this to make well-informed decisions about your health; knowing exact numbers can help you evaluate trends over time.
- Look at trends, not a single snapshot. Compare today’s lab results to those from six, 12, or 24 months ago to see where your health may be trending.
- Consider a more comprehensive panel. Many standard workups, such as what’s part of a basic blood panel at your annual physical, can be limited in the markers that are looked at and the information they provide. At MIORA, for example, the metabolic profile includes testing more than 70 biomarkers. These are run through a proprietary algorithm alongside a detailed symptom inventory to correlate how you feel in addition to what the labs show.
- Seek a provider trained in integrative or functional interpretation. “This isn’t about dismissing your primary care physician,” LaValle emphasizes. “But enlisting the support of a team who’s equipped to work in the ‘gray zone’ before disease strikes can help get your health trending in the right direction.”
- Start with “no-regret” lifestyle changes. Even as you pursue deeper evaluation, you can dial-in behaviors that are good for everyone, including managing blood-sugar, optimizing protein and fiber intake, improving sleep regularity and stress management, and getting plenty of movement. “These all are likely to influence the very markers we’re trying to optimize,” says LaValle.
