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The Pitfalls of Reference Ranges


Reference ranges, also known as normal ranges, are used to interpret the results of blood tests. They are based on the results of blood tests conducted on a large population and are used to determine whether a test result is within the normal range or outside of it. While reference ranges can be useful for identifying abnormal test results, it is important to note that they are not always the best rules to follow. Here are a few reasons why:

  1. Reference ranges can vary: Reference ranges can vary from lab to lab and may also be affected by factors such as age, gender, and ethnicity. This means that a test result that is within the normal range for one lab may be outside of the normal range for another lab.

  2. Reference ranges are based on averages: Reference ranges are based on the average values of a large population that all went to the same lab you went to. The problem is; who are the people that tend to go to the lab? Sick people. Healthy asymptomatic people aren't usually the overwhelming majority of people at the lab meaning constructing these reference ranges are based upon the average of a bunch of sick people. With that being said these reference ranges are likely not the most applicable tool to utilize when trying to get to the root issue of your current illness.

  3. Reference ranges do not take into account symptoms: Reference ranges do not take into account an individual's symptoms or overall health. A test result that is within the normal range may not necessarily indicate that a person is healthy, and a test result that is outside of the normal range may not necessarily indicate that a person is unhealthy.

Laboratory testing is not about the upper and lower limit of norms. Now of course those do play their part. But it's more so about looking at the ratios and patterns of various markers and being able to decipher trends. It really is an art. You have absolute and functional ranges and when things reach the absolute ranges that’s when we name the illness. However every illness has a course and if we can identify that course and intervene before you reach the absolute range then the outcomes for the patient are much more splendid. Think about it like this if Im running a 100 yard dash I don’t just snap my fingers and end up on the other side of the finish line. I actually have to run through the 10 yard line and the 20 yard line and 30 and so on. Now on that journey you will run through some functional changes and and we should be able to say I don’t like where this is heading how about we step in before things get out of hand. If we can locate an issue at let's say the 60 yard line we can now intervene earlier instead of waiting until you’re crawling across the finish line. Overall, it is important to consider reference ranges as a guide, but not as a definitive rule. It is important to work with a healthcare provider to interpret test results and to consider an individual's unique health needs and circumstances.

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