Correlating Lab Values with Symptoms with Functional Nutritionist Andrea Nicholson

I am a big fan of using labs to identify imbalances in the body. There are so many imbalances that can go unnoticed because they don’t directly cause symptoms. And because there are many symptoms that can arise from a variety of imbalances.  Correlating lab values with symptoms, when possible, is key to identifying the root cause.

In order to most effectively and efficiently get to know the root cause of your symptoms, we need to know exactly what’s going on. However, labs aren’t the end all be all information, we have to combine the lab results with your symptoms. So today, we’re talking all about how we analyze symptoms in the context of lab values, and how we analyze lab values in the context of symptoms. 

Symptoms in the context of lab values 

Sometimes lab values come back out of range, this could be out of the laboratory reference range, or outside of the functional or optimal range. And sometimes when this value is out of range, it correlates perfectly with what the client is feeling or experiencing. This is super helpful when the symptom that they’re dealing with can come from numerous causes. 

Take something like fatigue, for instance. Fatigue can come from dehydration, nutrient deficiencies, sleep deprivation, stress, blood sugar imbalances, an infection, and immune system activation. It can come from lots of different things. Sometimes when these values correlate perfectly with something that causes fatigue, then we have our answer. It’s really super helpful. 

But what about when the labs come back “normal” from a reference range standpoint? Well, this is a really common scenario, where your conventional doctor may tell you that everything is fine, you’re normal, this is all in your head, or this is a normal part of aging, or any number of other explanations that really aren’t helpful. 

But if we look at those same lab values from an optimal perspective, we may see that there are some imbalances that could be contributing to your symptoms. We may also be looking at markers that conventional medical providers just don’t run. For instance, I like to run a fasting insulin test with my clients to fully assess blood sugar handling, insulin resistance, and overall metabolic functioning. If you are struggling to lose weight, have fatigue in the afternoons, or you experience things like shakiness, tiredness, or irritability when you can’t eat, you may have some metabolic dysfunction. 

Many medical providers are only looking at fasting glucose and maybe hemoglobin A1c. But these markers often take decades to increase. Fasting insulin raises much faster and earlier in the progression of insulin resistance. So we can get on it much quicker if we’re looking at the proper labs. 

And lastly, your labs may come back within the optimal range, and yet you’re still experiencing symptoms. You’re not crazy, nor are you doomed to be sick. We see this a lot with things like hormones and nutrient markers. You have all of the classic symptoms like a thyroid imbalance, but your labs are perfectly within range. 

What this often means is that you’re making adequate amounts of the hormones, and all of the systems are working properly, but the hormones can’t enter the cell where they need to do the work. If they can’t enter the cell properly, they might as well not exist. They’re useless to you. But your labs look great. So the root cause here is we have to figure out why your cells aren’t allowing these hormones or nutrients to enter properly. 

Lab values in the context of symptoms 

So like I said at the beginning, labs aren’t the end all be all. They are merely a spot check…one small snapshot in time. They can be wrong.  An imbalanced marker may not be a true representation of your normal daily values. They can be thrown off by infections, dehydration, and many other factors. 

Some labs will show you potentially serious issues that don’t actually need to be addressed. We see this sometimes in things like stool tests. A serious pathogen may show up as being present, but you have no signs of acute illness.  This likely doesn’t need to be addressed. It could be a transient microbe, it could be lingering from a past infection, or it could just be that you’ve adapted to having that particular microbe in your system without causing harm. 

I also see this sometimes when looking at lab values of healthy people who are undergoing routine testing that isn’t necessarily due to any particular symptom they’re trying to address. This can show up in markers like thyroid panels.  Take me for instance. My lab values might cause alarm because I have lower levels of both T4 and T3. But I have no symptoms of hypothyroidism. I’m not the coldest person in the room, I’m not gaining weight, losing my hair, or struggling with depression or constipation. I clearly don’t have an underperforming thyroid.  I just need less thyroid hormone than the “average” population. This is likely due to the fact that I eat a low-carbohydrate diet, and I’m often in nutritional ketosis. When I’m not in a sugar-burning mode, I need less thyroid hormone. 

And lastly, many lab values or identified imbalances don’t correlate with symptoms. You can have elevated liver enzymes, or an immune system activation without necessarily creating symptoms. 
  • So the bottom line is we have to look at the overall picture. Some lab values need to be addressed, even if you’re not experiencing symptoms because they might be silently trending toward disease. 
  • Some lab values should not be addressed without symptoms being present. 
  • And some symptoms need to be addressed even if lab values are normal. 
A truly holistic approach is needed. How these imbalances get addressed also varies by what’s going on with you and your labs. The holistic approach would clearly address quality nourishment, appropriate exercise, sleep, stress management, and toxins. It may also include nutritional supplements or even recommendations for medications through your medical provider. 

This is why we can’t just look at labs, and we can’t just look at symptoms. We have to look at the totality of you because that is what matters. That’s why we’re here to help you feel your best.


Leave a Comment