Micromanaging Lab Results by Functional Nutritionist Andrea Nicholson

Micromanaging lab results isn’t the answer

Today, I wanted to share some details about a coaching conversation that I recently had with a woman about some recent bloodwork that she had done through her doctor. Frankly, she had become a little bit obsessed with the lab testing and had ended up having multiple rounds of testing done over the last month in an effort to micromanage every single value to perfection.

The problem is she had completely lost sight of her original mission, which was to reverse the symptoms that she was dealing with. Her symptoms specifically: she had really dry, brittle hair, and it was falling out in larger quantities. She felt like she was always cold and literally cold to the touch, even in really warm rooms, and even like in bed under blankets. And she also had this chronically dry skin. These were all the reasons that she originally went to see her doctor. They did this bloodwork, and they ultimately put her on some thyroid medications, because they realized that was her imbalance.

But now she was trying to micromanage her blood values. She was trying to bring every single marker on her blood test into the perfect range. But she wasn’t paying attention to those symptoms anymore. She wasn’t paying attention to whether or not her hair was getting better, or she was feeling less cold than she had been. Or if her skin was actually improving. She wasn’t paying attention to that at all, she was just hyper-focused on the blood values.

Medications can alter blood values

But…she was on medications for the thyroid. And what I had to remind her is that some medications and some supplements actually alter what your body is making on its own. So this can cause your lab values to look like they’re off. But it’s because you’re artificially supplementing with what your body wasn’t producing well to begin with. So in her case, she was on a thyroid medication that involves both T4 and T3. But this caused her TSH value to be really, really low. This is normal and totally expected.

So what normally happens in the body is your pituitary releases TSH, that TSH goes to your thyroid and tells your thyroid to produce T4 and a little bit of T3, the T4 ultimately gets converted to T3 and that’s what’s active in the cells. But when you’re taking a T4 and/or T3 medication, your brain gets the signal that it doesn’t need to produce TSH, because it’s not trying to stimulate the thyroid to produce those hormones, because you’re taking those hormones in the form of the medication.

So it’s natural and totally normal for, in this case, the TSH to be really low while on the medication. So you don’t actually want to hyper-focus that TSH value back into the optimal, non-medicated level. Your body doesn’t need it. So this is actually normal.

Patterns, not individual markers

We also really don’t want to hyper-focus on individual markers on the test. We’d rather look at overall patterns. Individual markers can be influenced by lots of different things that don’t necessarily provide us with all of the information necessary to get you to optimal health. We really want to look at overall patterns.
  • How is your blood sugar handling?
  • How is your cardiovascular system operating?
  • How are your blood cells and your iron status doing?
  • How are your nutritional deficiencies and your electrolytes?
  • How is your liver and your gallbladder?
  • How is your overall thyroid function?
  • What about your immune system and inflammation?
  • And what about your kidneys adrenals and dehydration status.

Natural rhythms

We also need to keep in mind that we have natural rhythms from day to day, throughout the day, from week to week, and throughout the month. And we have cycles that we all go through, especially as women, but all of us have cycles where various markers will be higher or lower. We have natural rhythms that can make it look like particular metrics are out of balance, when in reality, we just happen to catch it at a high point or a low point in the cycle, or in the rhythm. These are totally normal rhythms, and nothing has gone wrong.
When we look at overall patterns, we’re more likely to pick up on those things. Because maybe you have one marker that shows high, but everything else on your panel is normal. And when we look at prior testing, you were always totally fine in that one marker that’s now showing elevated. This is most likely just the rhythm or cycle.

Outside influences

We also need to remember that individual markers can also be affected by outside activities or influences. So for example, if you were to do a strenuous workout, right before you have your blood drawn, or really anywhere within 24-72 hours of having that blood drawn, that workout can alter some of your blood markers. For instance, your liver enzymes can show elevated, your protein breakdown markers can show elevated, your electrolytes might show some imbalances, you might be more dehydrated than normal…just because of the workout. If we know you’ve worked out, we can take that into account. If we know ahead of time, we can advise you not to do a workout before your bloodwork. But if you get bloodwork back, and some of these things are showing elevated or depressed, that might look kind of scary.

It might be scary to see your liver enzymes are elevated. But if we know that you worked out, that might be the cause for your liver enzymes to be elevated. These are normal things that happen when you work out, some of your tissue does get damaged in the workout. That’s what makes you build back stronger. That’s what helps you get stronger from workout to workout. This is totally normal. But it looks like a problem on your bloodwork without the proper context.

Other things like what you’ve been eating recently can make a big impact on your electrolyte balance or the lipids in your blood. Lots of different markers can be affected by what how much and how often you’ve been eating. And was this a fasting blood test or not? That also makes a big difference in what your blood values will show. If you’re dealing with an infection, or you just got over an infection, a lot of your markers can be affected. Even if you didn’t realize you were sick. Even if you didn’t know you had an infection. Our immune systems are constantly battling various things every single day, you may not even know that you had an infection, but your body is fighting the infection and it can show up in your blood work.

Stress can also do this. If you’re dealing with a lot of stress or a big change in your stress load, it can change how your body responds and how your blood work comes back.

Same thing with sleep if you didn’t sleep well, or if you didn’t drink enough water. All of these things can play a huge role in what those individual values show.

Individual differences

And lastly, we really have to pay attention to you as an individual, you personally may feel your best when particular values are higher than other, optimally healthy people. You may feel best with slightly lower values than the other populations. Based on your diet, age, genetics, and lifestyle, you may need more or less than other optimally healthy people. These are totally normal. So we have to take you into account when we’re looking at this testing.

Now, we talked a lot about today with individual blood testing. Because this is what most of us do. We go to our doctors, they run bloodwork every year. This is pretty standard fare for us. But this also the same concepts apply regardless of what testing you’ve undergone. If you do a stool test. If you do a urine test if you do a saliva test, a hormone test. I don’t care what it is. There are individual differences. There are rhythms, there are outside influences. All of this information applies to every single test. So this is why it’s so important to work with a professional who can help explain these values to you. How to you understand why individual markers might be off, or overall patterns might be off, and that might be totally okay for you. But we can also help you understand where overall patterns might be concerning and how they correlate with what you’re dealing with, what symptoms, you’re still battling, what struggles you’re still having.

Questions about your labs

So if you have lab work that either your doctor didn’t explain to you at all, or if you got some lab work that you’re concerned about or unsure of, let me know – I’m happy to help interpret what I can. I certainly don’t know every test on the market, but I will do my best to help you out. All you have to do is schedule a complimentary consultation, and let’s talk about it. Let’s walk through what you have, so that we can put your mind at ease. And just know that micromanaging lab results is never the path to optimal health. Just like micromanaging your diet is never the path or micromanaging your exercise or micromanaging your thoughts. Every little thing matters. But really, we need to take the overall you into account.

So if this information is helpful to you, I would love it if you would share this information with someone else who needs it. And like I said, if you have questions, please reach out. I know the vast majority of people get bloodwork done with their doctors and their doctors don’t say anything about it. Unless there’s something really, really out of whack, you never hear about it again. But I think there’s a lot of value that can be gleaned from every single test. So it’s worth talking through.


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