What Should You Do When Your Test Results Come Back Normal … But You Feel Anything But Normal

Something is wrong. You know it, deep in your bones, in the same way you know that the sun will rise tomorrow and that your “normal” test results aren’t telling the full story. 

So, what’s really going on?

Why test results come back normal

Here’s the deal: When we’re unwell, we head to the doctor. The doctor may give us a routine exam and then books us in for blood tests and if required, other laboratory/imaging tests. These tests are meant to reveal if something is wrong. But what they’re actually designed to do is either confirm a diagnosis or assess the severity of a condition. 

Notice the theme there? Traditional tests often represent late-stage findings – aka a problem that has already, physiologically speaking, fully manifested. With most chronic diseases, these effects only appear after a latency period.

This means by the time your test results show up as abnormal, a disease or illness has already manifested – even though physiological dysfunction – that is, changes at the cellular or tissue level – may have preceded those abnormal lab results by months or even years. 

This is because these tests are designed to see if you fit a particular disease pattern or pathology. And fitting the pattern means that you have progressed to a disease state. 

But the spectrum of our health is so much more complex than those black and white labels. Normal is not always normal. 

And, by “normal”, I mean healthy. But when medical practitioners refer to normal results, what they really mean is the reference ranges that represent “average” populations. 

But average populations aren’t healthy. 

The average health state is unhealthy

95% of people will fall into “normal” ranges when they receive their test results. 

Spoiler alert: It likely isn’t because their results are optimal. 

The issue isn’t the blood test per se, but rather the ranges used on traditional laboratory tests. These ranges are based on statistics and not whether a certain value represents good health or optimal physiological function.

About 15 million people in England have a long-term or chronic health condition. Long-term conditions or chronic diseases, these are conditions (for example, diabetes, chronic obstructive pulmonary disease, arthritis and hypertension) for which there is currently no medical cure. Instead, they’re managed with drugs and other treatments. 

It was expected that by 2018, 2.9 million people would be living with three or more chronic conditions. In the US, which has a population of over 300 million, six in ten adults have a chronic disease, and four in ten have two or more chronic diseases.

So, most people who feel “unwell” will come out as normal on blood tests … but are miles away from being functionally optimal (which is where you should be aiming).

This state is referred to as dysfunctional. This means their physiological systems are no longer functioning properly, and they are starting to feel unwell. But, unfortunately, it’s still “too soon” for the doctor to detect an established problem – because it hasn’t been established yet. 

And if it seems a little silly to wait until a disease exists before encouraging your body to heal and reverse dysfunction, you’re absolutely right. It’s like holding off on putting out a fire and waiting for your house to burn down so you can rebuild. 

Yet, that’s the traditional approach to health. The historical orientation of conventional healthcare systems has always been towards acute care. The implication of this is that care practices favour a focus on high-risk individuals rather than lower population-level risks.

There is also a strong bias towards tertiary or speciality care rather than prevention. The health sector exhibits low competency and capacity for acting on the root causes of chronic diseases that affect physiological function years before the expression of symptoms. 

But what if we didn’t have to wait until our proverbial home was burned down? What if we could pull out the healing hoses now?


Conventional laboratory tests versus functional lab tests

The good news is that we can! By using a systems-based approach like functional medicine, it is possible to identify and address the root cause of disease.

Unlike conventional medicine, the functional approach to blood tests is oriented around changes in physiology (function) rather than pathology.

Consequently, these tests may allow for more effective and proactive therapeutic interventions at earlier stages of the disease or dysfunction.

The ranges are based on optimal physiology and not the “normal” population, resulting in a tighter “functional physiological range”. This allows us to evaluate the area within the “normal” range to detect changes in physiological function and reveal if something is not quite right. 

Additionally, functional lab tests don’t simply look at one individual biomarker at a time in a linear report. Instead, they use trend analysis between the individual biomarkers to unearth hidden trends towards or away from optimal functional health.

By using this level of data, we can then identify the factors obstructing you from achieving optimal physiological, biochemical and metabolic functioning in your body.

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Curious why trend analysis is so important? 

Chronic diseases usually have multiple root causes. Any one of these root causes may contribute to many different diseases or disease processes. And although many conditions will have multiple contributors, not all contributors need to be present for a given condition to arise.

In conventional medicine, a doctor will use symptoms, signs, and other clinical indicators to develop a differential diagnosis. In functional medicine, we use the seven core imbalances to develop a differential understanding of dysfunction. 

A diagnosis often results from more than one imbalance. For example, Type 2 diabetes can result from many imbalances, including inflammation, physical inactivity, nutrient-deficient and pro-inflammatory diets, stress and toxin exposure. 

The exact manifestation of each disease and dysfunction depends on the individual genes, environment and lifestyle, and only the treatments that affect the right cause will have lasting benefits beyond symptom suppression.

Which is why testing shouldn’t just be about identifying disease and monitoring it. Focusing purely on disease allows many unwell people to slip through the cracks. 

What to do after your test results come back normal

First, I want to validate that if you’re not feeling well – or if you feel like something is off and not quite right – you ARE right. Trust your gut. Your feelings are real – even if your test results aren’t supporting them. 

And just because you’ve received normal test results, that doesn’t mean you have to pretend you feel normal. You know you best. If you think there’s more to the story, then there is. It’s as simple as that. 

But if conventional medicine isn’t helping you get closer to finding answers, it could be time to explore functional medicine. 

Functional lab tests can help give a clear picture of what’s happening across your systems to assess clinical imbalances and provide clarity on what’s really going on.  

To better understand your bodily function, a functional blood test, for example, will assess around 92 biomarkers (compared to around 20 through the health system) to give us a more comprehensive view of the processes and functioning of the body. 

Functional testing also focuses on optimal ranges as opposed to waiting for humans to move into a disease state. This allows us to work proactively and preventatively. 

This list is an example of some of the biomarkers we can examine:

  • Blood sugar regulation – via glucose, haemoglobin A1c, insulin and leptin
  • Metabolic function – eGFR, uric acid, potassium, CO2
  • Inflammation/oxidation – hsCRP, homocysteine and fibrinogen
  • Vitamins – 25 OH-D3 (vitamin D3) and methylmalonic acid
  • Thyroid function – TSH, total T4, free T4, total T3, reverse T3, TPO antibodies and TG antibodies
  • Lipids – Cholesterol – total, triglycerides, LDL, LDL-P, HDL, vLDL, apolipoprotein a1, Lp(a)-P

At The Thrive Practice, these results will allow us to:

    • Assess whether there are imbalances in any of the seven core processes in your system.
    • Spot any trends taking you closer or further from optimal health functioning. 
    • Develop a lifestyle-based health action plan so you can begin the process of healing or…
    • Uplevel your health action plan with a personalised nutrition plan to support your body’s journey to wellness.      

To learn more about how you can access functional laboratory testing via The Thrive Practice, please visit our Health Shop. You can also book in for a Free Pre-Test Consultation to get some advice on the best test for you.


Hello, I’m Leah! Functional health consultant and founder of The Thrive Practice. Driven by data and supported by science, I’m unerringly obsessed with exploring your unique biochemistry to methodically get to the root of your health issues. So, you can achieve real and lasting relief.


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