Skip to main content

Interpreting Results

Putting it all together—how to analyze your lab results, identify patterns, and take informed action.

📖 The Story​

Click to expand

After years of health optimization, Chris had accumulated a folder of lab results. Each test, viewed in isolation, had been declared "normal." But something wasn't adding up. He felt far from optimal.

He sat down with all his results side by side and started looking for patterns.

His fasting glucose had crept from 84 to 92 to 96 over three years—each time "normal," but clearly trending in the wrong direction. His ferritin had dropped from 82 to 45 to 28—never flagged, but a clear decline. His vitamin D was stable at 32—"sufficient" but never optimal.

More revealing were the connections: his declining ferritin correlated with increasing fatigue. His rising glucose matched his increasing waist circumference. His stable-but-suboptimal vitamin D coincided with more frequent illness.

"Each number seemed fine in isolation," Chris realized. "But the story they told together was that I was slowly heading toward metabolic dysfunction, fatigue, and immune weakness. The trends mattered more than any single test."

With this insight, he made targeted changes. A year later, his trends had reversed. Not because any single number had been "abnormal," but because he'd learned to read the pattern.

The lesson: Individual lab values are data points; patterns over time are the story. Learning to interpret results holistically reveals what single tests miss.

🚶 The Journey​

The Interpretation Framework

The Four Layers of Interpretation:

LayerQuestionExample
Single ValuesIs this optimal, not just normal?Glucose 96 is "normal" but not optimal
TrendsWhich direction is this heading?Glucose 84→92→96 is concerning trend
PatternsWhat story do related markers tell?High TG + Low HDL + High glucose = insulin resistance
ContextWhat else is going on?Recent stress, poor sleep, medication changes

🧠 The Science​

How to Read Lab Results

Understanding Reference Ranges​

Where Lab Ranges Come From:

  • Based on 95% of "normal" population
  • Population may not be healthy
  • Don't account for individual variation
  • Updated infrequently
  • Wide to capture statistical variation

Lab Range vs. Optimal:

MarkerLab RangeOptimalGap
Fasting glucose65-99 mg/dL70-85 mg/dLUpper "normal" is pre-diabetic
TSH0.4-4.5 mIU/L1.0-2.5 mIU/LUpper "normal" may be subclinical hypothyroid
Vitamin D30-100 ng/mL50-80 ng/mLLower "normal" associated with worse outcomes
Ferritin15-150 ng/mL50-150 ng/mLLower "normal" causes symptoms

Key Ratios and Calculations​

More Informative Than Single Values:

RatioFormulaOptimalWhat It Shows
TG/HDLTriglycerides ÷ HDL<2.0 (<1.0 ideal)Insulin resistance
HOMA-IR(Glucose × Insulin) ÷ 405<1.0Insulin sensitivity
BUN/CreatinineBUN ÷ Creatinine10-20Hydration, kidney, protein
T3/Reverse T3Free T3 × 10 ÷ RT3>0.2Thyroid conversion
Neutrophil/LymphocyteNeut % ÷ Lymph %1-3Inflammation, stress

Common Patterns​

Metabolic Dysfunction Pattern:

  • Fasting glucose: 92-99 (upper "normal")
  • Fasting insulin: >8 (working overtime)
  • Triglycerides: >100
  • HDL: <50 (men) or <60 (women)
  • Waist circumference: increasing
  • HbA1c: 5.5-5.6% (creeping up)

Iron Deficiency Pattern:

  • Ferritin: <30 (often <50 is symptomatic)
  • Serum iron: Low-normal
  • TIBC: Elevated (body trying to grab more iron)
  • Transferrin saturation: <20%
  • Hemoglobin/Hematocrit: May be normal initially
  • MCV: May be low (if progressed)

Thyroid Dysfunction Pattern:

  • TSH: Upper normal (2.5-4.5)
  • Free T4: Mid-range
  • Free T3: Low-normal
  • Reverse T3: Upper normal or high
  • TPO antibodies: May be elevated
  • Symptoms: present despite "normal" labs

Inflammation Pattern:

  • hs-CRP: >1.0 (ideally <1.0)
  • Ferritin: Elevated (not from iron overload)
  • ESR: Mildly elevated
  • WBC: Upper normal
  • Fibrinogen: Elevated
  • Homocysteine: >10
## 👀 Signs & Signals

Red Flags in Lab Results​

Immediate Attention:

  • Glucose >125 mg/dL (diabetes range)
  • HbA1c >6.5% (diabetes range)
  • TSH <0.1 or >10 (significant thyroid dysfunction)
  • Potassium <3.0 or >6.0 (cardiac risk)
  • Creatinine rising significantly
  • Extremely high liver enzymes
  • Very low hemoglobin

Worth Investigating:

  • Glucose 100-125 (prediabetes)
  • TSH >4.0 or <0.4
  • Vitamin D <20 (deficiency)
  • B12 <300 (functional deficiency likely)
  • Ferritin <30 (common cause of symptoms)
  • hs-CRP >3.0 (significant inflammation)

When Labs and Symptoms Don't Match​

Labs "Normal" but Symptomatic:

  • Check optimal ranges (not just lab ranges)
  • Look at trends
  • Request additional testing
  • Consider functional medicine evaluation
  • Trust symptoms—labs don't capture everything

Labs Abnormal but Asymptomatic:

  • Early detection opportunity
  • Don't dismiss just because no symptoms
  • Investigate root cause
  • Monitor and intervene

🎯 Practical Application​

How to Interpret Your Results

Gathering and Organizing Results​

Create Your Health Database:

  1. Collect all past lab results
  2. Create spreadsheet or use tracking app
  3. Include date, values, reference ranges
  4. Note any relevant context (illness, stress, medications)

Key Categories:

  • Metabolic: Glucose, insulin, HbA1c, lipids
  • Thyroid: TSH, Free T4, Free T3
  • Blood cells: CBC
  • Inflammation: hs-CRP, ESR, ferritin
  • Nutrients: Vitamin D, B12, iron panel
  • Liver/Kidney: CMP markers

Sample Tracking Template:

DateMarkerValueRef RangeOptimalNotes
1/15/24Glucose9465-9970-85Fasted
1/15/24HbA1c5.4<5.7<5.4—
1/15/24Vit D3230-10050-80Winter
## 📸 What It Looks Like

Comprehensive Lab Review Example​

Patient: 45-year-old with fatigue, brain fog, weight gain

Recent Results:

MarkerValueRef RangeOptimalStatus
Fasting glucose9865-9970-85⚠️ High-normal
Fasting insulin142-252-8⚠️ Elevated
HOMA-IR3.4—<1.0🔴 Elevated
HbA1c5.6%<5.7<5.4⚠️ Borderline
TSH3.20.4-4.51-2.5⚠️ High-normal
Free T32.42.3-4.2Mid-upper⚠️ Low-normal
Vitamin D2830-10050-80🔴 Insufficient
Ferritin3515-15050-150⚠️ Low-normal
hs-CRP2.8<3.0<1.0⚠️ Elevated
Triglycerides142<150<100⚠️ Elevated
HDL44>40>60⚠️ Low
TG/HDL ratio3.2—<2.0🔴 Elevated

Pattern Analysis:

  1. Metabolic Dysfunction (Primary):

    • HOMA-IR 3.4 = significant insulin resistance
    • TG/HDL 3.2 confirms
    • HbA1c 5.6 = prediabetic range
    • Likely driving fatigue, brain fog, weight gain

  2. Thyroid Suboptimal:

    • TSH high-normal with low-normal Free T3
    • May be conversion issue (stress, insulin resistance)
    • Contributing to symptoms

  3. Inflammation:

    • hs-CRP 2.8 elevated
    • Likely related to metabolic dysfunction

  4. Nutrient Deficiencies:

    • Vitamin D insufficient
    • Ferritin low-normal (may cause fatigue)

Priority Action Plan:

PriorityActionTimeline
1Address insulin resistance: ↓ carbs, resistance training, post-meal walksStart now
2Vitamin D: 5000 IU dailyStart now, retest 3 months
3Iron support: dietary focus, possibly supplementEvaluate in 4 weeks
4Full thyroid panelRequest at next visit
5Retest metabolic markers3 months
## 🚀 Getting Started

Your Interpretation Process​

Week 1: Gather

  • Collect all available lab results
  • Request copies from providers if needed
  • Create tracking spreadsheet or system
  • Note dates and relevant context

Week 2: Analyze

  • Identify flagged abnormal values
  • Compare all values to optimal ranges
  • Plot trends over time
  • Identify patterns

Week 3: Plan

  • Prioritize issues to address
  • Research evidence-based interventions
  • Identify what you can do yourself
  • Identify what needs provider help

Week 4: Act

  • Implement lifestyle changes
  • Start appropriate supplementation
  • Schedule provider appointment if needed
  • Set reminder for retesting

Ongoing

  • Maintain health database
  • Update with new results
  • Track response to interventions
  • Adjust based on progress
## 🔧 Troubleshooting

Common Interpretation Challenges​

"Everything is 'normal' but I feel terrible"

  • Check optimal ranges, not just lab ranges
  • Look for borderline values
  • Look for adverse trends
  • Request additional testing
  • Consider what standard panels don't include
  • Symptoms matter—labs don't capture everything

"I don't understand what my results mean"

  • Focus on one category at a time
  • Use resources to understand each marker
  • Ask provider to explain
  • Consider health coach or functional medicine consultation
  • It's a learning process—build knowledge over time

"I don't know what to prioritize"

  • Address immediate risks first
  • Then high-impact, reversible issues
  • Then optimization
  • You don't have to fix everything at once
  • Start with most symptomatic issues

"My results keep fluctuating"

  • Some variation is normal
  • Check consistency of testing conditions
  • Look at trends, not individual tests
  • Average multiple tests if very variable
  • Investigate cause of variability

"My provider dismisses my concerns"

  • Prepare specific questions and data
  • Reference optimal ranges respectfully
  • Consider second opinion
  • Functional medicine often more thorough
  • You're allowed to advocate for yourself
## 🤖 For Mo

AI Coach Guidance​

Assessment Questions:

  1. "What do your recent lab results show?"
  2. "How do your current results compare to previous tests?"
  3. "What symptoms are you experiencing?"
  4. "What patterns do you notice?"
  5. "What have you already tried?"

Key Coaching Points:

  • Help identify patterns
  • Explain optimal vs. normal ranges
  • Connect symptoms to lab findings
  • Suggest additional testing if appropriate
  • Encourage provider partnership

Important Boundaries:

  • Cannot diagnose conditions
  • Cannot create treatment plans
  • Refer to healthcare providers for abnormal results
  • Education and pattern recognition, not medical advice

Example Scenarios:

  1. "How do I read my lab results?":

    • Start with flagged values
    • Compare to optimal ranges
    • Look for patterns (metabolic, thyroid, etc.)
    • Consider trends over time
    • Connect to symptoms
    • Discuss with provider

  2. "My labs are normal but I have symptoms":

    • "Normal" lab ranges are often too wide
    • Check optimal ranges for each marker
    • Look at borderline values
    • Consider what wasn't tested
    • Request additional testing if indicated
    • Provider evaluation important

  3. "What should I work on first?":

    • Prioritize immediate risks (abnormal flagged)
    • Then symptomatic issues
    • Then optimization opportunities
    • Consider which changes have biggest impact
    • Start with lifestyle before supplements
    • Track and adjust
## ❓ Common Questions

Q: How often should I get comprehensive labs? A: Annual comprehensive panel is baseline. If actively optimizing or managing a condition, every 3-6 months for relevant markers. Once stable, less frequent is fine.

Q: Should I fast for all blood tests? A: Fasting (12-14 hours) is important for glucose, insulin, and lipid panels. Most other tests don't require fasting. Water is fine and helps blood draw.

Q: How do I know if trends are significant? A: Significant trends show consistent direction over multiple tests. Single-test fluctuations are normal. If a value has changed substantially (even within range) or is moving toward abnormal, that's meaningful.

Q: What if my provider uses different reference ranges? A: Reference ranges vary by lab. Compare your results to the ranges on YOUR lab report. Optimal ranges are more consistent. If concerned, use optimal ranges as your goal regardless of lab ranges.

Q: Can I interpret results myself or do I need a professional? A: You can learn to identify patterns and optimize. But abnormal results, complex patterns, or persistent issues warrant professional evaluation. Self-education + professional partnership is ideal.

## ✅ Quick Reference

Interpretation Checklist​

For Each Test:

  • Is any value flagged H or L?
  • Are borderline values near optimal?
  • How does this compare to previous tests?
  • What direction is the trend?

Pattern Recognition:

  • Metabolic: glucose, insulin, TG, HDL, HbA1c
  • Thyroid: TSH, Free T4, Free T3, antibodies
  • Iron: ferritin, serum iron, TIBC, saturation
  • Inflammation: hs-CRP, ESR, ferritin
  • Nutrients: vitamin D, B12, magnesium

Context Factors:

  • Recent illness or stress?
  • Test timing (fasted, time of day, cycle day)?
  • Medication or supplement changes?
  • Symptoms present?

Key Optimal Ranges​

MarkerOptimal
Fasting glucose70-85 mg/dL
Fasting insulin2-8 μIU/mL
HOMA-IR<1.0
HbA1c<5.4%
TSH1.0-2.5 mIU/L
Vitamin D50-80 ng/mL
Ferritin50-150 ng/mL
hs-CRP<1.0 mg/L
TG/HDL ratio<2.0

💡 Key Takeaways​

Essential Insights
  1. Lab normal ≠ optimal—aim higher than reference ranges
  2. Trends matter more than snapshots—track over time
  3. Patterns tell stories—related markers reveal root causes
  4. Context matters—timing, symptoms, lifestyle affect interpretation
  5. Calculate key ratios—TG/HDL, HOMA-IR are highly informative
  6. Trust symptoms—labs don't capture everything
  7. Partner with providers—self-education + professional guidance is ideal
## 📚 Sources
  • Institute for Functional Medicine - Lab Interpretation Guidelines Tier B
  • American Association for Clinical Chemistry - Lab Tests Online Tier A
  • Attia, Peter - "Outlive" (optimal ranges approach) Tier C
  • Research on optimal vs. reference ranges Tier A
  • Pattern recognition in metabolic dysfunction Tier A

🔗 Connections​