What Lab Ranges Don’t Tell You: The Truth About Normal vs. Optimal

As a doctor of nursing practice and certified fertility awareness educator with additional training in integrative, functional, and herbal medicine, I often get asked my opinion and insights on when or if hormone testing should be done. Lab tests can be a wonderful tool to aid in our understanding of our cycles, hormones, fertility, and bodies but there are limitations - so let’s talk about what those are and how you can potentially use them to take control of your hormonal health journey.

Normal vs Optimal Ranges

Standard lab ranges are established based on averages for specific populations. A traditional Western provider will use the normal ranges to determine whether you should have support or further workup, while a functional or integrative, more holistic provider often uses optimal lab ranges to support clients.

Standard lab ranges help identify abnormal results (eg. very high or low) necessary to diagnose medical conditions such as hypothyroidism, PCOS, menopause, etc.  

Functional or optimal ranges (what I personally use) are typically “tighter” or more personalized ranges for clients that support optimal fertility, health, and well-being rather than just preventing or treating frank disease states. The beauty of this approach is that since our cycles are downstream from the rest of our systems when our hormones and cycles are optimized, so is our overall health! 

What to Test - the Functional Approach

Having detailed testing, alongside a provider that understands how to interpret your results, through a holistic lens is key to getting the support you need to improve and address your symptoms. I regularly see women denied testing that would be helpful for them because insurance won’t cover it or because providers are not educated on deeper more integrative testing to support fertility and hormone balance.

When testing hormones it’s also likely that a single blood test will not capture the full picture, especially as hormone levels fluctuate naturally throughout your cycle and should be timed accordingly.

I personally like to use a functional medicine approach to look at the root cause of a client's issues. With this approach, instead of just looking at hormones we are looking to see why hormones may be “off” and then to customize a plan for the individual.

Hormone labs that can often be helpful to look at are:

• A full thyroid panel
• Menstrual cycle hormones
• Adrenal hormones

I prefer using the DUTCH testing for cycle and adrenal hormones because it gives a deeper breakdown of the hormones and how your body is processing them which is more actionable than just blood cycle hormones. 

Some additional testing I often include with clients are: 

• Gut microbiome testing
• Food sensitivity/food inflammation testing

Additional blood work to look at:

• Blood sugars
• Nutrient deficiencies
• Cholesterol
• Kidney health
• Liver health
• Inflammation

Viewing the WHOLE picture

It’s important to understand that you should never use labs alone to determine treatment or conditions. A medical provider should always be looking at the whole person when they interpret or recommend labs - this includes considering the individual’s diet, lifestyle, mindset, physical movement, stress, sleep, environment, relationships, and underlying health conditions. 

In my personal health journey, and that of my clients, I find cycle tracking and tracking symptoms WITH labs and interventions over time to be critical in supporting our bodies and their wisdom! This approach allows us to see what is and isn’t working for our body so that we can continue to optimally and efficiently support our systems to a state of thriving.