• Barbara Johnson, MD

When Normal isn't Normal

Updated: Feb 10


When Normal Is a Warning Sign

You feel it first when your health starts to break down; you just don’t function the way you used to. Whether it’s fatigue, brain fog, or low energy, you know something isn’t right. So you visit your primary care physician looking for a diagnosis. After labs and a physical, you’re told that everything is normal.

While it’s always great to get an “all clear” from your doctor, you’re still left with health concerns. Though your blood tests were “within normal limits,” sometimes issues like low energy or brain fog presage the start of a more serious condition. Chronic illnesses develop over years, sometimes even decades, as minor imbalances evolve into serious abnormalities.

Sometimes, normal isn’t normal.

Prevention = Optimal

Blood work is the best way to detect and prevent chronic disease, but only if the physician looks for optimal values and not for disease. That is, ‘normal’ lab values don’t always indicate health, particularly low or high normal values. Let’s look at blood glucose, which is a critical test.

For reference, the normal range for fasting glucose is 65 to 99 mg/dl. However, a Kaiser Permanente Study tracked 46,000 people for 10 years and found that prediabetic conditions can be present even when an individual’s blood test is technically normal. The study showed that for every point above 84 mg/dl, your risk of diabetes increases; at 90 mg/dl, your diabetes risk increases by 49%. The study also revealed that at 90 mg/dl and above, vascular and kidney damage may begin to develop.

But most doctors, focusing on the “normal” range, only become concerned when levels reach 100mg/dl, at which point organ damage may have already started and the risk for diabetes has climbed a staggering 84%. While diabetes is bad enough, it also increases your risk of heart disease, cancer, dementia, Alzheimer’s, obesity and many other health conditions.

You don’t develop diabetes overnight, and symptoms like fatigue, brain fog, or low energy could be early symptoms. Watching your blood sugar rise within the ‘normal’ range could mean that your health is deteriorating and that your risk of developing diabetes is increasing. If caught at an early stage, this trend can be reversed with diet, exercise, and supplements.

Aim for Optimal

Properly interpreted, lab tests can tell you when you are at risk of developing certain conditions. They can indicate when you need to make critical changes to your lifestyle or start treatment, which can add years, even decades to your life.

Most physicians don’t act until values outside the “normal” range indicate the presence of disease. Functional physicians focus on optimal values to help prevent disease. Because for many tests, like blood glucose, normal can be a warning sign.

Barbara L Johnson, MD is an integrative/functional physician who helps her patients achieve optimum health, productivity and longevity. She practices out of her offices in Blacksburg, VA and Mount Airy, NC. You can contact her at thejohnsoncenter@gmail.com.


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