There are few things more satisfying than opening up your bloodwork results and seeing a beautiful little row of NORMAL, NORMAL, NORMAL. No red numbers. No giant H for high or L for low. Everything sitting nicely between those two little numbers the lab has so graciously provided. Fantastic. I am the picture of health. See you next year.
Not so fast.
I recently found myself going down a rather large rabbit hole about bloodwork and what those “normal” ranges actually mean. I will spare you most of that journey because at one point I was reading about reference populations and statistical distributions and even I wanted out. But I did learn something I think everyone should understand about their annual bloodwork.
Normal is a reference point. It is not necessarily a gold star.
Those ranges printed next to many of your results are called reference intervals. For many common tests, they are generally designed to include about 95 percent of the values found in a selected reference population. That also means some perfectly healthy people will naturally fall outside the range. Different tests have different rules, and some medical cutoffs are based on disease risk rather than this 95 percent approach, but the basic point is the same. Your lab result needs context.
This does not mean you shouldn’t trust your bloodwork. You absolutely should. Your result is still your result. What I don’t want you doing is looking at the word normal and assuming that one word tells you everything there is to know about your health, especially if you feel like crap.
I can’t tell you how many times I’ve had a client tell me, “I am always tired even though I’m getting nine hours of good sleep,” or “I feel foggy all the time” or “by noon my energy is completely gone.” They go to the doctor, have their annual bloodwork done, everything comes back within range and suddenly the conversation is over. “Well, everything is normal. So I guess I’m fine.”
Except you don’t feel fine.
And somewhere along the way, I think we have gotten a little too comfortable pushing through that. The bloodwork says normal, so maybe we’re just getting older. Maybe we’re too busy. Maybe this is what 40 feels like. Maybe we’re being dramatic. Maybe we just need another cup of coffee. No.
Your routine annual bloodwork is incredibly valuable, but it is not an inventory of every single thing happening inside your body. A complete blood count looks at your blood cells. A comprehensive metabolic panel gives your doctor information about things like your blood sugar, electrolytes, liver and kidney function. Your physician may also order cholesterol, A1C, thyroid testing or other labs based on your age, medical history and risk factors. There are many, many other things that can be tested, but there is no reason to test every person for everything every year.
That’s where symptoms matter.
If you are sleeping well but you’re exhausted, constantly foggy, unusually weak or simply know that something has changed, “normal” bloodwork shouldn’t automatically become the end of the conversation. It can become the beginning of the next question. “Okay, I see that these results are within range, but I still don’t feel right. What else should we look at?”
Maybe the answer is another blood test. Maybe it isn’t. Your doctor may want to look more closely at iron stores, thyroid function, vitamin deficiencies, medications, sleep quality, nutrition, hormones or something entirely different based on your symptoms and history. More testing isn’t always better, and ordering dozens of random labs can actually create more confusion. The point is not to demand tests. The point is to keep asking reasonable questions when your body is telling you something has changed.
This is also where I think we need to get much better at knowing our own numbers.
Most of us only have to keep track of one person: ourselves. Your physician may be responsible for hundreds of patients. I would love to believe that before I walk into an appointment, my doctor has studied up on me like there is going to be a quiz. I want them looking through my old labs, remembering what happened three years ago, noticing that something has slowly been changing and, ideally, recognizing that I got a new haircut. I don’t think that’s asking too much. And many great physicians make every effort to do at least three out of those four things.
But I also live in reality.
Doctors are human. They have packed schedules, enormous patient loads and limited time. Things can fall through the cracks. Here in the Keys, we have another problem. Keeping health care professionals here can be difficult. Medical professional retention has specifically been identified as a problem across the Keys, and our most recent Monroe County health assessment continues to list access to health care as a major local concern.
That means the doctor looking at your bloodwork this year may not be the doctor looking at it three years from now. The days of having the same family physician from age 25 to 75 aren’t a guarantee any more. That makes knowing your own health history even more important because you may be the only person who has been there for the entire thing.
Which is why I think reviewing your own bloodwork should become part of your annual self care. Not diagnosing yourself. Not Googling one slightly elevated number at 11:30 at night and deciding you have a rare tropical disease. Not marching into your doctor’s office waving a TikTok video and demanding 17 additional tests. I mean simply paying attention.
Pull up last year’s bloodwork when you get this year’s results. Better yet, look back several years if you have them. Compare the same values. Are they relatively stable? Has something been slowly climbing? Has something been slowly dropping?
This assumes, of course, that you can actually get into your patient portal.
Patient portals were apparently designed to improve our access to health care information, which is wonderful once you remember which portal this particular doctor uses, reset the password you definitely reset six months ago, wait for a verification code that never arrives and discover that your bloodwork is inexplicably hiding under a tab called “Documents.” At that point, requesting paper copies starts to feel cutting edge.
But however you get them, keep them.
Let’s say your fasting glucose comes back at 98 and the lab considers that within range. Great. But what if you look back and see that it was 78 several years ago, then 84, then 89, then 94 and now 98? That doesn’t automatically mean something is wrong with you. It does mean you now have a very good question to bring to your doctor.
That is the part I want people to understand. Sometimes the most useful information isn’t whether this year’s number landed one point inside or outside a box. It is what that number has been doing over time. One blood test is a snapshot. Several years of bloodwork starts to look more like a story, and nobody should know that story better than you.
Keep copies of your labs. Look at them once a year. Compare them. Pay attention to how you actually feel. If something has changed, ask about it. And if you’re told everything looks normal but you still don’t feel normal, don’t assume the problem must somehow be you. Ask the next question.
Your job isn’t to become your own physician. Your job is to become an active participant in your own health care. I still want my doctor looking at my numbers. I still want their training, experience and medical judgment. But I also know they have a whole lot of people to look after.
I only have one, and I think she’s worth studying up on.
