How To Read Blood Work From A Functional Medicine Perspective
and
Why “Normal” Isn’t Always Optimal
When you get your blood test results and your doctor says, “Everything looks normal,” yet you still feel fatigued, sluggish, or unwell—what does that really mean?
The term normal in conventional blood work is based on population averages, but 60% of adults have a chronic disease, 40% will develop cancer, and 20% have a diagnosed mental health condition. If these are the people defining “normal,” do you really want to fall into that range?
Functional Medicine takes a precision-based approach, looking at optimal levels, not just averages. Instead of waiting for disease, we look for early dysfunction—subclinical imbalances that could explain why you’re not feeling your best.
Factors That Can Affect Blood Work Results
Before drawing conclusions from your results, it’s important to consider:
🔹 Training/Exercise – Avoid strenuous activity within 3 days before testing (affects ALT, CK).
🔹 Fasting – Recommended fasting time is under 10 hours to avoid falsely high triglycerides & insulin markers.
🔹 Alcohol – Avoid for at least 3 days before testing.
🔹 Medications – Some medications (steroidal, pancreatic, thyroid hormones) can influence results.
🔹 Dehydration – Ensure proper hydration (750mL+ daily for 3 days prior) to avoid falsely elevated values.
🔹 Supplements – Pause certain supplements before testing for accurate readings.
🔹 Sleep – Aim for 8 hours of sleep (affects BHA & overall test reliability).
🔹 Illness – Blood work should be done at least 3 weeks after illness to avoid skewed inflammatory markers.
🔹 Pregnancy – Hormonal changes can impact thyroid, iron, and other markers.
🔹 Food Reactions – Avoid testing within 3 days of a negative food reaction.
🔹 Iron Infusion – Wait at least 6 weeks post-infusion for accurate iron levels.
Key Differences Between Conventional & Functional Blood Work Analysis
1️. Conventional Ranges vs. Functional Ranges
- Conventional ranges detect
- Functional ranges assess optimal health and early dysfunction before disease develops.
- Example: The standard reference range for liver enzymes (ALT) in the U.S. is higher than in South Korea because the population has more liver disease. Does that mean you want to be in that range? Probably not.
2️. Blood Work Is Not Just About Individual Markers
- In Functional Medicine, we connect the dots instead of looking at isolated markers.
- Example: Low-normal iron might not be “clinically low,” but if it’s paired with fatigue, hair loss, and low ferritin, we don’t ignore it.
3️. Ratios Matter More Than Single Values
- The body functions as a system, so ratios provide a clearer picture than just one number.
- Examples:
- Sodium:Potassium Ratio – Reflects adrenal function & hydration.
- Neutrophil:Lymphocyte Ratio – Can indicate hidden infections or chronic inflammation.
- T3:Reverse T3 Ratio – Helps assess thyroid function & metabolism efficiency.
Common “Normal” Blood Work Findings That Might Not Be Normal
1️. Thyroid Tests That Miss The Full Picture
- If you’ve only had TSH tested, you’re missing the full thyroid story.
- What to ask for? A full panel including T3, T4, Reverse T3, and thyroid antibodies.
2️. Low-Normal Iron That Still Causes Fatigue
- A “normal” ferritin of 20 may not be anemic, but optimal levels for energy are 50-100.
- Iron levels should be correlated with B12, folate, and inflammation markers.
3️. Cholesterol Is More Than Just “Good” and “Bad”
- LDL isn’t always bad; context matters.
- A low LDL with high inflammation (hs-CRP) is more concerning than a high LDL alone.
What You Can Do Next
🔎 Check Your Own Blood Work for These Signs
✅ Have you been told you’re “normal” but still feel exhausted, foggy, or inflamed?
✅ Have you had only TSH tested and not a full thyroid panel?
✅ Do you see trends over time (e.g., declining iron, shifting cholesterol, elevated fasting glucose)?
If you’ve experienced any of the above, don’t stop at “normal” bloodwork—look deeper!
Please be aware that some of what Dr. Ailina discusses, including investigations on how to get to the bottom of the root causes of your symptoms, are not fully covered by Medicare and not addressed unless you book a Functional Medicine appointment with her.
Unfortunately, most of these aspects are not included under conventional medical practice. To obtain information about her Functional Medicine consultations, please call the medical centre and request the introductory information to be emailed to you.
Disclaimer
All content and media on the www.hampsteaddrivemc.com.au website is created and published online for informational purposes only. It is not intended to be a substitute for professional medical advice and should not be relied on as health or personal advice.
Always seek the guidance of your doctor or other qualified health professional with any questions you may have regarding your health or a medical condition. Never disregard the advice of a medical professional or delay seeking it because of something you have read on this website.
