Normal Is Not Always Optimal
Allen Holmes, MD

Have you ever gone to your doctor because you were experiencing symptoms that were
concerning or bothering you? Maybe you were fatigued or lacked energy? Or you were having
difficulty losing weight? Maybe you were working out a lot but not getting any stronger or
faster? Your doctor may have done lab work on you and you were told “Your labs are are
You may have wondered what does normal mean? You may have thought, “if they are normal,
then why do I feel the way I do?” Perhaps you left frustrated and not knowing what you should
do next since everything is normal.
Have you ever wondered how normal lab values or reference ranges are determine? It is a very
complicated process beyond the scope of this article. In simplified terms, lab results are
obtained from a “healthy” population. The mean (average) of those results are calculated and
then the reference range is determined. It is usually plus or minus two standard deviations
from the mean. Reference ranges also take into account sex, age, and other determinants.
Let’s not focus on the calculations but rather on how is “healthy” population defined? Are
these people with no medical problems? Are they all thin? Do they all eat healthy and
As our population becomes more obese (current rate is 41.9%) and have an ever increasing
incidents of chronic diseases such as diabetes, hypertension, etc. the definition of “healthy”
population must become more lenient, or else there wouldn’t be much of a population left to
base reference ranges on.
Furthermore, factoring in age as a determinant for reference ranges can be problematic. These
values will adversely decline or rise as we age, thus the older we are the lab reference ranges
allow us to have deteriorating numbers and still be normal.
What if we chose to not accept this deterioration in lab values and the deterioration in health
and vitality accompanied with them? What if we didn’t settle for normal values for a 60 or 70
year old, but instead desired to have normal values of a healthy, robust, fit 35 year old?
Here is an example: According to Labcorp the normal reference range for Free Testosterone in
females is 0.0-4.2 pg/dl. Zero testosterone is normal.
Are we asking the wrong question? Should treatment always be based on normal or
abnormal? Or should we be seeking what are optimal lab values? What lab value should we
strive for safely that will allow us to have the most vitality, energy, longevity and health span?
Normal is not always optimal. Let’s go for optimal!

If you feel something is missing or suboptimal in your health and wellness, whether it be
achieving your weight loss goals or hormone optimization reach out to our team at
Biosymmetry Wilmington and schedule a consult.