How to read your pathology tests

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When it comes to a simple blood test, it’s never quite as simple as it looks. Or rather, it’s never quite as simple as it should be. Pathology test results are often either misread or the information is not utilised properly. We can tell so much about the state of our health by a quick and easy blood test, so it’s important to know how to read and interpret the results to get the information you’re looking for (or perhaps the hidden clue that you were missing). I wanted to use this blog to show how we can use our results to give us more powerful information, and improve our health overall. 

I had a patient recently that I was discussing this with and I think it’s a really important concept to consider when receiving your blood test results. So, often, people will say I went and saw the doctor and had my bloods done and everything was fine. But to most naturopaths or integrated practitioners, that’s not enough, because what we really need to see is what does that mean and what did they test first of all, and then what is their interpretation of the results? So, even I find sometimes when results are outside of the pathology lab ranges, doctors will still say “it’s fine.” 

And to throw my two cents in, because I want what’s best for you, when we’re looking at blood test results, I’m actually not that convinced that what the pathology lab thinks is a good reference range is actually a good reference range. So, when you think about how that pathology lab created that reference range of what it considers as normal. It based it on a bulk of the average population that has had that test previously and they do the average of that.

So, when we’re looking at, let’s say, the average population out in the world, I would say you would probably agree with me that the majority of people aren’t optimally healthy. There’s a lot of people in the society that really are not optimally healthy and their results will be contributing to what the pathology lab results reference range will be. So, often, probably a neat way to start looking at this is kind of cutting the bottom third and the top third and looking at that middle range, the optimal range that one-third in the middle. That’s usually what I will look at to in the case, a healthy range. And, of course, there are some parameters, for instance, liver enzymes that having the lower range is actually better and so that’s where having a professional to help you interpret that result is really important. 

But if you’re wanting to look on your own, here are some tips to help you:

  • Be your own health advocate. Don’t be afraid to explore possible tests with a doctor that you think might be helpful. Doctors have a lot of restrictions on testing and it is important to respect that they may not be able to assist, but if you know there is something not right in your body it is important to dive deeper. This is where a natural practitioner may be helpful, as we like to encourage you to go deeper. 
  • Keep a record. Always keep a health file with a copy of EVERY investigation you have, and always ask for a full copy. Keep this file for life and add to it over time. This information can be very valuable to any health care practitioner you might see. For me when someone comes in with a file of tests it is like Christmas! So much information can be gleaned.
    • You can also set up My Health Record which is a government initiative and can ask for all of your tests to also be added there for future access.
  • Invest in further testing. Sometimes it is worth spending money on testing outside of the Medicare model. There are a lot of tests that usually won’t be ordered that could be very useful for identifying underlying issues in complex or non-improving cases. There are blood tests, but also functional pathology testing such as stool, urinary and saliva that can assess markers that are not usually seen in traditional pathology investigations.
  • Who you ask matters. Get a second opinion if you are not happy with the answers you are getting. If you feel unwell and your doctor says you are healthy according to your blood tests (this is incredibly common), don’t just settle with that. Keep going until you find someone who is willing to investigate further (if I had a dollar for every person I see that has been told that it is in their head and that they should take antidepressants, I would be living on a private tropical island).
  • You are unique. Reference ranges can be used as a guide but remember we all have bio-individuality. For instance, someone with ferritin levels at 30 (a typical bottom end of the normal range) may feel great, and the next person may feel bone-tired until they are somewhere up around 80+. Our bodies absorb and utilise different nutrients and different ways.
  • Health is more than mathematics. If you notice a number in your pathology results that is very close to the bottom or the top of a range (or just outside it) this warrants further investigation or retesting. What may now be determined as okay could develop into an issue quite quickly.
    • Typically speaking, functional and integrative doctors and naturopaths have their own tighter parameters for interpreting results.
  • Read between the lines (or ask an expert to do this for you). Sometimes there are clues in results that seem unrelated. For example, a ‘slightly high’ but within range TSH (thyroid-stimulating hormone), plus high LDL (low-density lipoproteins or bad cholesterol) could indicate subclinical hypothyroid even though the TSH looks ‘normal’. Or a ‘slightly low’ but in range vitamin B12 and a ‘slightly high’ but in-range MCV (mean corpuscular volume or the average size of red blood cells) could indicate vitamin B12 deficiency, despite the B12 being in the normal range.

While it’s important to dive deep into your health for the sake of your overall wellbeing, it’s important to remember where traditional doctors and pathology labs are coming from. The work that they do is based on hard science, because that’s the model of healthcare they work with. It’s not to say that one approach is right as the other is wrong, but rather the two can work harmoniously to help achieve the best possible outcomes for you.

When these two fields recognise each other, we can see amazing shifts. Let’s take a look at this example of lowering standards with semen analysis results. The reference ranges are set by the WHO and parameters for sperm count, sperm motility and sperm morphology have dropped significantly every decade for the last three decades. The WHO bases its updates on a large pool of data of average results, which shows that sperm health is declining each decade (and quite alarmingly so). The standards now set for today’s man would have been below optimal even just one decade ago, let alone two and three decades ago. This is just one example of declining health in an area that we now consider ‘normal’, and it directly influences pathology testing.

As you’ve likely gathered, pathology testing (or blood testing) isn’t as simple to read as it looks. There’s lots of tips that I am happy to share (the most important of course is being thorough with your health), but if you want to take a deep dive into your own results, let’s work together one-on-one.

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