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40: Dr. William Graham | What Are ‘Normal’ Lab Values?

AIR DATE: June 20, 2013 at 7PM ET
FEATURED EXPERT: Dr. William Graham
FEATURED TOPIC: “What Are ‘Normal’ Lab Values?”

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Have you ever gotten back test results from your doctor and were relieved to see that you were in the “normal” range with your lab values? Did you ever stop to ask yourself how they came up with these numbers? What if you are in the normal range on a particular test, but you still have symptoms in your health that make it obvious you are still not well? These are just a few of the questions we addressed in this week’s episode of “Ask The Low-Carb Experts” with a low-carb/Paleo-friendly family physician named Dr. William Graham from King, North Carolina. He has a special interest in measuring fasting insulin and ketone levels as well as testing his patients for vitamin deficiencies. As you will quickly see, Dr. Graham is quite opinionated and more than willing to stretch the boundaries of “traditional white coat medicine.” That made him the perfect choice to answer YOUR questions about the topic What Are ‘Normal’ Lab Values? on this week’s show.

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Here are just a few of the questions addressed in this podcast:

KELLY ASKS: I’ve read that the “normal” ranges on most lab tests are actually averages of all the tests results that the lab has conducted. Why this is so frightening to me is because most of the people who are having tests run have something WRONG with their health. This means the supposedly “normal” values are really clouded with a lot of sick people’s numbers and the more tests run on sicker people the more “normal” sick actually becomes. Is this actually how it works or do I have it all wrong?

LESLIE ASKS: As with modern infant growth charts, I often wonder what’s considered normal these days. My family doctor has joked with me that according to her charts I should be dead with blood pressure of 110/60 and a resting heart rate of 54 as a woman in my late 50s.

SIMON ASKS: I’m a lean, fairly healthy 26-year old man and I’ve been following a low-carb ketogenic diet since the beginning of April 2013 because I didn’t like feeling constantly hungry on a high-carb diet. I had a blood test done at the end of May and my uric acid levels were out of the normal range measuring 7.2 mg/dl. The normal range specified is 3.6-7.0 mg/dl. Should this be cause for concern? Are my kidneys perhaps still adapting to the presence of ketones? By the way, my total cholesterol is 223 mg/dl and my triglycerides are 139 mg/dl.

EDWARD ASKS: I was wondering if the lab standards for blood pressure are somehow biased. I’m an American born citizen of Asian descent and lived on a diet of rice for many years. It never bothered me that my blood pressure was considered Stage One Hypertension as I personally felt fine. However, with the medications I’m taking, I now feel tired and sluggish simply with the goal of lowering my blood pressure because it’s not in the right range. Can you help me understand this?

LISA ASKS: I had a regular CBC done recently and my BUN level came back as 23. The lab test states that normal is between 7-18. The doctor hasn’t recommended anything for me to do about this. I follow a lower-carb diet compared to the SAD diet and I don’t eat a lot of sugar. Should I be concerned about my BUN levels being so high?

TONY ASKS: Other than the typical blood test markers physicians run to gauge the general health of their patients, what are the top 5 blood markers people should be paying most attention to after the age 40? Are they different for males vs. females?

ARI ASKS: What do you think about the seemingly high prevalence of low-carbers, including Jimmy, who have very high LDL-P numbers but no other signs of imminent heart disease risks? I realize there is very little research on this right now, but would love to hear Dr. Graham’s personal experience on this subject working with patients eating a low-carb diet.

KEN ASKS: Between the standard lipid panel, NMR Lipoprofile test, CMP panel, and CBC panel, which 3-4 numbers should folks be most concerned about to determine their cardiovascular and overall health risks?

RICHELLE FROM AUSTRALIA ASKS: What is the significance of lactate in the blood particularly in the context of mitochondrial function? What other blood markers are good to keep an eye on to monitor mitochondrial function? Also, what are the best tests to monitor nutrient requirements in the body?

  • Wenchypoo

    I agree with Dr. Graham that more and more doctors are “doctoring by numbers” with these high, low, and bold test scores. I’m currently in a standoff with my own doctor over my cholesterol–she doesn’t bother (or doesn’t know how) to take into account that I’m a Paleo low-carber who uses various saturated fat sources due to my long list of food allergies, so yes my LDL isn’t going to be within Big Pharma’s target range. She’s aware of my allergies, but seems to focus on the test numbers rather than me, the patient.

    Four times now she’s tried to sell me Welchol. I’m going to start offering her cans of coconut milk in return. I offered her chard out of my garden one year, and she just looked at me–she didn’t know what chard was! she herself eats processed foods, and wonders why her own LDL is out of whack.

    Soon, I’m going to make the switch to a bariatric doctor who is familiar with low-carb Paleo patients (and hopefully eats real food).