If you’re reading this post, do you feel sick, but your labs are normal? Or perhaps this has happened to your partner or another family member. I had the experience myself, after the birth of my first child. I couldn’t sleep or think straight. All my energy went towards keeping an inner sense of stability. And yet, my screening tests were normal. As a doctor, I concluded I didn’t have a disease, I must be fine. It took me a couple of years of breaking down before I would break open to a new way of seeing: symptoms are simply our bodies’ ways of communicating imbalance or deficiency.
Here are 5 things you can do if this happens to you:
1. Trust Your Body
I believe the deepest level of healing is learning to trust your body. In our culture, we’re taught to push past our symptoms, that they somehow signify weakness. Or we’re inclined to deny them, that they somehow interfere with our capacity to live our lives. But what are symptoms other than signs of imbalances that need correcting? These imbalances might be caused by nutrient deficiencies, allergens, inflammation, stress, infections, or toxicities. When you’re not feeling your best, it’s your body’s way of saying, “Pay attention.”
2. Get Additional Testing if Possible
Keep in mind that additional tests aren’t always necessary or indicated. Either the tests aren’t available yet, or they might give false positives or negatives and lead to more testing, which can be expensive and indeterminate. If further testing is available, commonplace, and could be helpful—ex: a full thyroid panel or vitamin D levels—ask your doctor if s/he would be willing to screen you. If not, or if the tests are more specific, like hormone levels, commercial labs like Life Extension have packages you can order on your own. Bringing these results to your next doctor’s appointment could be useful to open up the dialogue more.
3. Take Control of Your Health
While awaiting next steps, take a closer look at your diet and stress levels. Diet and stress make up the bulk of contributors to chronic disease. Under “stress,” I also include lack of community. Doctors aren’t trained in nutrition or lifestyle medicine, so rarely do they make specific recommendations. The best place to start with diet is to eliminate processed foods. A shift from a prepackaged, refined diet to whole foods is the single most important factor. As for stress, “management” is a better goal than “reduction,” because stress seems to be entrenched in modern lifestyles. Besides, it is the perception of stress rather than the stressors themselves that perpetuates chronic inflammation. An easy place to start is improving your HRV, or heart rate variability, by checking out www.heartmath.org. A second easy step is to “earth” yourself. Go outside to your backyard or any grassy area and stand or walk in your bare feet for 30 minutes.
4. Bring a *Concise* Symptom Journal to Your Doctor’s Appointment
Journaling your symptoms along with your diet, your stresses, sleep/wake cycles, and, if you’re a woman, your menstrual cycle, can be helpful to pinpoint the root imbalances. A good history and physical is worth more than a battery of tests.
“Normal” usually means your lab values fell between “the reference range.” This is a range compiled from testing large numbers of patients for a particular serum marker, then finding the average. Some reference ranges are very wide; often, this means what might be optimal for one person might not be optimal for another. Another reason your test might show up normal when there is an underlying issue is that the test is incomplete; for example, the standard celiac panel tests only for the alpha sub-fraction of gliadin protein, but there are currently 10+ known gliadin sub-fractions. Or, serum magnesium levels may be normal, but magnesium works inside your cells, which is a much harder level to ascertain.
Don’t forget about lab error. No test is 100% accurate. It’s reasonable to ask for a repeat test, especially during a time you’re having active symptoms.
When I was in medical school, my beloved mentor said, “A good history and physical is 90% of your diagnosis and treatment.” Make sure you have a doctor who listens to you, one who validates your experience, even if the tests are inconclusive. Good doctor-patient relationships are a necessary foundation for true healing.
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