Your Blood Tests Are “Normal” — So Why Do You Feel So Unwell?

In my previous blog, I talked about the human body as an incredibly complex ecosystem, with the gut, microbiome, immune system, hormones, brain, thyroid, metabolism and mitochondria all communicating with one another. This is exactly why I find it so frustrating when somebody who feels profoundly unwell is told that everything is “normal” simply because a handful of blood results have fallen within a laboratory reference range.

I hear this constantly. Someone knows that something has changed in their body. They are exhausted despite sleeping, their brain feels foggy, their joints ache, their digestion isn't right, they are gaining weight, their hair is thinning, their mood has changed, their periods have become different or they simply feel as though their vitality is disappearing. They go for blood tests hoping to finally understand what is happening, only to receive a message saying, “Everything is normal.”

But they don't feel normal, and that matters.

We Need to Look at the Person, Not Just the Numbers

Blood testing can give us incredibly useful information, but a blood test is a snapshot of certain markers at a particular moment in time. It isn't a complete assessment of everything happening inside a human being.

This is where I think we have lost sight of the bigger picture. If we accept that the body is an interconnected ecosystem, as I discussed in my previous article, then surely we also have to accept that looking at one marker in isolation can only tell us so much.

Take somebody experiencing exhaustion, brain fog, aching joints, poor digestion and hormonal symptoms. I don't see five unrelated complaints. I want to know when they started, which came first and what was happening in that person's life and health at the time. I want to know about their nutrition, digestion, bowel movements, sleep, stress, medications, nutrient status, blood-sugar regulation, thyroid and hormones. I want to see their previous blood results and understand whether anything has been gradually changing.

The person is the story. The blood results are simply part of the evidence we use to understand that story.

“Within Range” Doesn't Necessarily Mean Optimal

Laboratory reference ranges are useful, but I think people often misunderstand what being “within range” actually means. A result can sit towards the lower or upper end of a reference range and still technically be described as normal.

This is why I don't like the conversation ending with, “Your bloods are normal.”

I want to know what the actual numbers are.

If somebody has been feeling progressively worse for three years, I also want to know what those same numbers looked like three years ago. A result may still be sitting inside the laboratory range while moving significantly compared with that person's previous results.

The body doesn't suddenly become unwell the moment a number crosses a laboratory cut-off. Health doesn't work like a light switch where everything is fine at one number and suddenly broken at the next.

There is often a journey.

And that journey is where I believe we have an enormous opportunity to start paying attention.

What Was Actually Tested?

This is another question people rarely ask.

When somebody tells me, “I've had all my bloods done,” I ask them what was actually tested. Quite often, they don't know because they were simply told that everything came back normal.

A standard set of blood tests cannot tell us everything about nutrition, hormones, digestion, metabolism, inflammation or thyroid function. Different symptoms and health histories may justify looking at different markers.

This is why I encourage people to obtain copies of their actual blood results rather than relying solely on the sentence, “They're fine.”

Look at what was tested. Look at the numbers. Keep previous results so that you can compare them.

Your health history doesn't begin on the day of your latest blood test.

Iron Shows Why the Bigger Picture Matters

Iron is a good example because somebody can present with exhaustion, weakness, poor concentration, hair shedding, headaches or reduced exercise tolerance, yet understanding their iron status can involve more than looking at one number.

Ferritin gives information about stored iron, while haemoglobin and the size and characteristics of the red blood cells can add further information. Depending on the circumstances, other iron markers may also be relevant.

I don't want to chase numbers for the sake of creating “perfect” blood results. I want to understand whether the results fit with the person sitting in front of me.

That distinction is important.

B12 and Folate Are Another Example

B12 and folate are involved in red-blood-cell formation, neurological function and numerous processes throughout the body. When somebody is struggling with exhaustion, poor concentration, brain fog or neurological sensations, nutrient status becomes one part of the picture I want to understand.

Again, I don't want to look at a number without looking at the person.

What are they eating? Are they taking supplements? Are they taking medications that may affect nutrient status? How is their digestion? Have they had gastrointestinal problems? What do their other blood markers show?

This is what I mean when I talk about looking at the terrain.

One marker is rarely the whole terrain.

The Thyroid Is Not an Island

This connects beautifully with the previous blog because we talked about how the endocrine system is a communication network.

Someone may come to me saying that they are exhausted, constantly cold, constipated, gaining weight, losing hair and struggling to think clearly. They may have had a thyroid test and been told that it was normal.

My question is: what was actually tested?

The thyroid doesn't exist independently of the brain, pituitary gland, nutrients, immune system, gut, liver and wider endocrine system. That doesn't mean that everybody experiencing fatigue has a thyroid problem, but it does mean that persistent symptoms deserve proper investigation rather than being dismissed simply because one result hasn't been flagged.

Again, I want the whole picture.

Blood Sugar Doesn't Suddenly Become a Problem Overnight

The same principle applies beautifully to blood sugar.

Nobody wakes up one morning with perfectly regulated metabolism and suddenly develops type 2 diabetes because a number crossed a diagnostic threshold overnight. There is usually a journey that has taken place beforehand.

Perhaps blood sugar has gradually been increasing. Perhaps the person has become constantly hungry, developed cravings, gained abdominal weight, started crashing after meals or noticed that their energy is becoming increasingly unstable.

Those changes matter.

This is exactly why I think we need to become much better at looking at the direction somebody's health is travelling rather than waiting until they have travelled far enough to acquire a diagnosis.

This Is Where Symptoms Become So Important

This brings me back to something I said in my previous article: I don't necessarily see symptoms as the enemy.

Sometimes the symptom is the body kicking us up the bum and saying, “Something has changed. Please pay attention.”

If your digestion has changed, that is information. If your energy has disappeared, that is information. If your menstrual cycle suddenly changes, that is information. If your joints begin aching, that is information. If your concentration deteriorates or your blood sugar starts creeping upwards, that is information.

The symptom doesn't automatically tell us the cause, but it gives us a reason to start asking questions.

This is why I find it so difficult when somebody knows that their health is deteriorating but feels that nobody is really listening because their results haven't moved far enough outside a laboratory box.

We Have Separated the Body Into Too Many Boxes

This is perhaps the biggest connection with my previous article.

We have become very good at separating the human body into departments. Digestive symptoms belong over here, hormonal symptoms over there, blood sugar somewhere else, joint pain somewhere else again and brain fog becomes another conversation altogether.

But there is only one person experiencing all of them.

The gut communicates with the immune system. The immune system communicates with the rest of the body. Hormones influence metabolism. The thyroid influences energy production. Nutrients are required throughout these processes. The liver, gut and kidneys are involved in processing and eliminating substances. The brain communicates constantly with the body.

Everything is connected.

So when somebody tells me that their digestion deteriorated first, then their energy disappeared, then their joints began aching, then their periods changed and now their blood sugar is increasing, I don't immediately want to give five separate names to five separate problems.

I want to know what changed in the terrain.

This Is Why I Ask So Many Questions

When somebody comes to see me, I want their story rather than simply their latest test results.

I want to know how they felt five years ago compared with today. I want to know which symptom appeared first and what happened next. I want to understand their food, digestion, sleep, stress, medications and supplements. I want to know what their periods are doing if relevant, how their energy changes throughout the day and whether there was an illness, stressful event, medication change or other significant event around the time their health began to deteriorate.

Then I want to look at their blood results within that story.

Sometimes the clue isn't one dramatic abnormality. Sometimes it is a collection of smaller clues that begin to make sense when we finally stop looking at them separately.

That, for me, is what looking at somebody properly actually means.

Stop Waiting for the Body to Scream

I believe there is an enormous space between feeling truly well and eventually being diagnosed with a chronic condition, and I think that space deserves far more attention.

We shouldn't have to wait until somebody's blood sugar is firmly within the diabetic range, their nutrient deficiency has become severe or their symptoms have become debilitating before we become interested in why their health is changing.

If the body is whispering, listen to it.

And if you have repeatedly been told that your blood tests are “normal” while knowing that you don't feel well, don't allow that one word to convince you that what you're experiencing doesn't matter.

Ask for your actual results. Find out what was tested. Keep copies of previous tests and look at how things have changed over time. Most importantly, keep asking why.

Because if the human body really is the extraordinary interconnected ecosystem I described in my previous article, then surely our approach to understanding health needs to reflect that complexity too.

Being “within range” is useful information.

But it isn't the same thing as understanding why you no longer feel like yourself.

And for me, that is the question we should have been asking all along.