All My Tests Are 'Normal' - But I'm Still Sick
Updated: Feb 2
There is a rush of adrenaline when a doctor’s office calls with test results - and a momentary panic when you envisage the worst.
When your results are normal, there is a wave of relief - but then comes the question, “so, what do I do next?"
On average, a doctor spends only 11 seconds listening to a patient’s symptoms and often runs only a single confirmatory test looking for a diagnosis.
When these results are 'normal' it can feel like a dead end.
Functional Range vs. Diagnostic Range
Normal or negative test results can be a medical 'no man’s land’ when you are looking for a diagnosis.
Without a diagnosis, usually you are without treatment, or an idea of what to do next.
But far from being definitive - a normal test result usually only indicates that your markers are within the reference range for that particular test.
This reference range was made to enable doctors to quickly determine whether your body is in a crisis or there is a disease present.
The reference range is an average of the general population. The problem is that the average population is not necessarily healthy.
If your test values are 'borderline' by functional medicine standards it can indicate that your body is not functioning optimally.
There are two references of lab values - diagnostic range and functional range.
A diagnostic range is used to see if there is something seriously wrong (like liver failure) or to determine a diagnosis.
A functional range enables doctors to identify problems and imbalances within the body before they become severe enough to be outside the reference range - and become a condition or symptom.
A functional medicine doctor specializes in interpreting functional range results which assess how well your body is functioning.
An initial appointment, preliminary testing or a diagnosis is the beginning, not the end, of a clinical investigation.
Treating the Symptom vs. Treating the Cause
Functional medicine addresses the rift in care and communication that can sometimes exist between the standard practice of conventional medicine and the patient.
Functional medicine is a comprehensive evaluation of the individual and relies on much longer appointments, extensive diagnostic testing and nutritional medicines that are intended to address the root cause of your symptoms.
There is much more to medicine than matching prescription medications to symptoms. Just because your symptoms do not categorically fit into a diagnosis does not mean nothing is happening.
Many people do not fit into a diagnosis easily, these categories are meant to sort large quantities of patients by what a majority of them is feeling.
Symptoms are the ‘alarm bells’ of the body.
Usually, the body is trying to find its way back to balance.
A fever is trying to kill off a virus by heating up the body so the virus cannot replicate. Autoimmune antibodies are attempting to defend your body but end up causing you pain, tissue damage and inflammation in the process. The pain and redness associated with a deep cut is the body speeding large quantities of blood to the afflicted area, and with it, the white blood cells that are going to heal you. The body 'wants' to heal.
The primary objective of most medications is to directly manipulate chemistry in the body to shut down symptoms - they do not usually address the source of the imbalance which caused the symptoms.
In some situations, medications are very useful and can save lives, but with chronic health problems most types of medication do not heal and can have many adverse side effects.
Many people gravitate to functional medicine to solve their various health issues.
In addition to those who do not have a diagnosis or those whose test results come back normal - patients who have adverse reactions to their medications, those with a diagnosis but are classified as severe or complex, and those who would prefer not to take conventional pharmaceuticals if it can be avoided - are all looking for a more comprehensive solution.
The utilization of genetics, patient history, family history, diet, lifestyle, stress level, previous test results, supplement usage, sleep quality are all factors that are highly informative of your overall health picture.
Example Patient: Dietary Intervention
I had a patient who had been to dozens of specialists and was on the verge of getting her colon removed due to severe inflammation and an inability to digest any food. She was losing weight alarmingly fast and in a great deal of pain.
After taking a detailed history and inquiring about her diet she assured me that the diet she was following was 'healthy' and that she had been to other doctors and specialists who have already ruled out her diet as a contributing factor to her condition.
I performed a comprehensive inquiry into her diet.
We discovered that she drank almost a half a gallon of milk every day and her body was reacting to the milk proteins triggering an inflammation cascade.
She was also reacting to the large amounts of cheese she was eating.
She believed that she could eat dairy in large quantities because she was told she was not lactose intolerant and that she needed the calcium.
Her medical history revealed that she was not reacting the to the lactose but rather the milk and dairy proteins. Without a thorough dietary inquiry, a dietary factor could be contributing to even the most serious conditions.
In her case, with her set of symptoms, dairy was highly inflammatory to her digestive track. After stopping milk consumption, her symptoms subsided over the course of a few days. She regained health and no longer needed an operation.
The inflammation caused by her diet was not obviously apparent on any standard test results.
There is still no good substitute for a thorough (at times, more than an hour long) appointment where the patient can get into every detail of their lifestyle, diet and condition.
The Limitations Of Testing
Tests are heavily relied upon in modern medicine - they can provide a window in to the inner workings of the body and illuminate processes that are not easily observable - but there are limitations.
The basic tests run by doctors are meant to assess only two things: is your health condition or status life threatening? And, do you have a set of symptoms and signs that can be classified into a diagnosis?
Diagnoses are useful for triage in an emergency setting but can be unhelpful for chronic health problems. A diagnosis comes with no explanation for why your set of symptoms is happening, or what to do next.
When you are ill, but your tests results are 'normal', it may be that the right tests were not done, the tests may not be interpreted properly, or what is going on is not easily detected through testing and a different method needs to be used.
There is always a reason you feel ill, and you deserve to be taken seriously.
Functional medicine may be right for you; with advanced testing, comprehensive appointments, research-backed nutritional medicines, and a focus on the prevention and treatment of chronic conditions - it has given many patients the solutions and knowledge they had been looking for.
If you would like to ask me questions about functional medicine, chronic illness or how I can help you, please schedule a Free 15 Minute Consultation or call or text my office at 913-728-5291.
If you think that you may have a medical emergency, call your doctor or 911 immediately. No action or inaction should be taken based solely on the contents of this information. Nor should you ever delay seeking medical advice or treatment due to the information contained on this Website.