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Some tests just shouldn't be graded on a curve

Has your doctor told you, "your blood test results are completely normal," but instead of feeling relief, you felt worse, knowing that something was wrong, but the doctor was unable to find any answers? 

Many naturopathic medical doctors and other functional medicine-oriented doctors question not the usefulness of conventional blood tests themselves, but the standard wide “reference ranges” – the ranges are often so large that they have little practical value.

For example, the most common laboratory test for hypothyroidism (low thyroid) is the Thyroid Stimulating Hormone. The common reference range is approximately 0.4 to 4.5 or 5.5 - a huge 10-to-13 times difference between the low and high range. The TSH “optimal” range of naturopathic doctors is a much narrower, 1.3-2.0.

What difference does it make to the patient? As in the TSH example, the optimal range-oriented doctor will more likely detect and treat the low thyroid, helping the patient to alleviate symptoms such as constipation, high cholesterol, weight gain, fatigue, hair loss, low libido, memory loss, etc. The doctor who diagnoses using only the standard range often will miss opportunities to help improve functioning of this critically important gland and provide relief to the struggling patient.

It is important to understand that conventional reference ranges are designed not on preventing disease or identifying patients outside of optimal human function, but on helping to diagnose disease states only. According to Dr. Dicken Weatherby, ND, an expert on blood testing, the laboratory medicine standard is to use 2 standard deviations above and below the mean, to include 95% of the population. As Americans become sicker and sicker the reference ranges are widened.

It is our experience as naturopathic doctors, Dr Weatherby says, that most people who seek care do not have a clinically identifiable disease. As a result, they are told by their doctor that they have an “unremarkable” or “normal” laboratory test. They may be normal compared to the rest of the sick population, but they are a long way from being in a state of optimal health.

For example, it is well known in the medical community that the white blood cell, “eosinophil” is elevated when there are intestinal parasites. The reference range is 0-7 to 9%. The optimal level is 0-3%. According to Dr. Weatherby, and what I have confirmed in my own practice, dozens of times, is when the following white blood cell pattern is present: 7% monocytes, 3% eosinophils and 1% basophils, intestinal parasites are probable. Yet, the standard reference range for monocytes (4-13%), eosinophils (0-7), and basophils (0-3) almost always misses parasites, except the most obvious cases.

How about you? Do you find any comfort in knowing that, compared to the rest of the population, that you are “normal,” even though you may feel unhealthy? What are your goals with your health, to merely avoid a disease, or to be optimally healthy and have vitality along the lines of let’s say, Jack LaLanne?

Dr. Dennis Godby, Doctor of Naturopathy, Sutter Medical Foundation.

He may be reached online or at his Sacramento Office (916) 446-2591.

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