Normal vs Healthy: Why Your Labs Look Fine but You Feel Awful
Episode Summary
Media marketing director Leah hosts this episode with Dr. Sasha Rose, a naturopathic doctor and licensed acupuncturist with over 20 years of practice and one of the lead providers at Med Matrix. The conversation centers on the gap between normal and healthy, the very common experience of being told your labs are fine while you still feel terrible. Dr. Rose explains that standard reference ranges are based on population averages that include both healthy and unhealthy people, so a result can land inside the range while the body has been struggling for years. She uses thyroid testing as a concrete example, noting that a TSH considered normal across a wide range may still reflect borderline low thyroid function. They discuss why conventional medicine often cannot dig deeper, pointing to insurance constraints and short five to seven minute visits, and the toll repeated dismissal takes on patients, including what Dr. Rose describes as medical trauma and feeling gaslit. She then walks through the comprehensive panels functional medicine starts with, from a full thyroid panel and insulin to ferritin, vitamin D, and a comprehensive stool analysis, all aimed at finding root causes. The episode closes on the idea that you do not have to settle for normal.
Key Topics
- 1
Why normal lab results do not mean optimal health for an individual
- 2
Where reference ranges come from and why they vary between labs
- 3
Thyroid testing and TSH as an example of normal versus optimal
- 4
How insurance constraints and short office visits limit conventional care
- 5
Common symptoms that standard blood work misses (fatigue, brain fog, sleep, digestion, mood)
- 6
Comprehensive stool analysis and markers for gluten sensitivity versus celiac
- 7
The emotional toll of being dismissed, including medical trauma and feeling gaslit
- 8
The comprehensive baseline panels functional medicine starts with
- 9
Catching early insulin resistance and pre-diabetes before symptoms appear
- 10
Root cause medicine versus band-aid medicine
Quotable Moments
“Normal labs does not always mean optimal for you as an individual. So the labs are designed to detect disease, but not to detect dysfunction that happens early.”
“It's not proof that something's wrong, and so you don't feel like yourself, you know something isn't right, but you're told, actually, everything is fine. You are fine.”
“We're catching people I'm catching a lot of people who are pre-diabetic and had no idea. And so it's a real incentive to make some lifestyle changes.”
“You don't have to settle for normal. And that we shouldn't be settling for normal and that's what we're sold, especially in health care.”
“Our first visit is 60 minutes. Our follow-ups are 30. It's unheard of for people to have that kind of time and attention in a visit.”
Treatments Mentioned
FAQ
Functional Medicine FAQ
Dr. Rose explains that normal reference ranges are based on population averages that include both healthy and unhealthy people, so a result can fall within range while your body has been struggling for years. Standard labs are designed to detect disease, not the early dysfunction that shows up before a number is technically out of range. Normal does not mean optimal for you as an individual.
Reference ranges are based on population averages, and that population includes both healthy and unhealthy individuals. There is no single universal range for a given test, and ranges can vary somewhat between labs. Because wide ranges include people with early dysfunction, a result can be labeled normal even when it is not ideal.
Dr. Rose notes that the standard reference range for TSH is often around 0.5 to 4.5 or 0.5 to 5, so many providers will say you are fine anywhere in that window. In functional medicine she prefers a narrower range, roughly 0.75 to 2, and reviews a full thyroid panel rather than TSH alone, since borderline low thyroid function can still drive fatigue, weight gain, and hair loss.
Dr. Rose points to two main reasons. Insurance often only pays for certain labs or medications when values hit a specific threshold, so a more thorough panel may not be covered when a result reads normal. Short five to seven minute visits also leave no time to dig into sleep, nutrition, cortisol, or the many other factors that contribute to symptoms like fatigue.
Yes. The comprehensive diagnostic stool analysis can check for an anti-gliadin antibody, gliadin being the protein in gluten. This is different from a celiac or allergy test, which is a yes or no result. Many people do not have celiac or a true allergy but still have a sensitivity to gluten that drives gut and inflammatory symptoms.
Dr. Rose describes starting with a comprehensive baseline that includes a full thyroid panel, a complete blood count, a comprehensive metabolic panel, fasting insulin (not just glucose), hemoglobin A1C, and micronutrients like magnesium, vitamin D, B12, and ferritin. The goal is to spot patterns and catch early issues, such as borderline insulin resistance or pre-diabetes, years before they would show up as disease.
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