What To Do When Your Lab Tests Are Normal, But You Still Feel "Off"
Here's how this scenario usually goes: You feel sick, tired or just "off." Like the smart, cautious person you are, you book an appointment with your primary doctor to get checked out.
The doctor runs some blood tests, and a few days later, you get a call from the office: "Hi, I'm Lisa from Dr. So and So's office, and we just wanted to let you know that all your blood tests came back normal! Have a great day!" Click.
Um, OK. Now what?
Almost all of us have gone through this experience of feeling sick, but receiving normal medical results. And in my many years as a medical student and practicing doctor, I've heard this story countless times.
I also know from personal experience how frustrating this can be: After I had my two children, I was struggling with what seemed to me like a "hormonal imbalance." And yet there was no testing that could diagnose my problem.
If a similar scenario has happened to you as well, here are some common reasons why you may be getting normal results:
1. There's been a lab error.
This happens more than you might think. And it's especially problematic when testing certain things like hormones, because the levels vary throughout the day and month. Tests can also vary due to food, exercise or supplements.
There are so many things that go into getting lab testing right. And if just one of those goes wrong, you end up with skewed results. Learn more about the steps a lab takes, and where errors might occur.
2. Your doctor didn't listen to your story.
As a physician, I really try to listen to the entire story before running tests. But sometimes, your doctor may not be hearing the full scope of what you're dealing with. Or, the ER doctor who is checking labs on you may think that your symptoms of palpitations sound like a heart problem — when it's really a thyroid issue. Want to prevent this from happening? Read more below.
3. Your illness isn't diagnosed by labs.
Subtle hormonal imbalances cannot be detected by traditional lab testing — even if they may not feel so subtle to you. And that's true of many other conditions including some autoimmune, malignant, allergic and viral diseases.
In fact, there simply may not be an adequate test in existence for your condition. In my field, I've seen this a lot with celiac disease or wheat allergy testing, where the results are normal but the patients get very ill after eating wheat products.
4. Your 'normal' isn't the same as optimal.
Optimal rates of thyroid, vitamin D, ferritin and so on are very different from "normal ranges" used in lab tests. After you receive your results, make sure to ask your physician if your levels are optimal, not just normal.
So your labs came back normal. Now what?
1. Listen to your body.
While you are waiting for answers and exploring other tests, aim to get more sleep, more recharge time, and better stress management. You'd be surprised how well that works for some conditions.
2. Get extended testing, if it's appropriate.
Remember more is not always better. Too much testing can be expensive and might raise false concerns. And sometimes your condition doesn't even have a lab test that can diagnose it. That being said, if you're working with a specialist physician for your problem, it may be helpful to look into having them order special testing that you haven't tried yet.
3. Bring a symptom journal to your next appointment.
This is a simple tool that really helps health care providers pinpoint your problem. Of course, a journal that's 40 pages long is not likely to be carefully read by a busy practitioner. But a clear, one-page summary of all your symptoms, when they happen, and what you were doing and eating at that time can be really helpful. This can lead the physician to think of things they may not have gleaned from your standard office history.
4. Tweak your diet.
The importance of diet is often completely missed by most doctors. For patients that are dealing with issues like low energy, I often tell them to start with a whole food, low-sugar elimination diet to see how that might help.
When I myself was struggling with hormone imbalance, I became frustrated with the medical system until I realized that sometimes these issues are very difficult to diagnose with labs and routine doctor’s visits. After reading countless books and talking to various friends, I decided to start with my diet and lifestyle — and finally found success.