Squeezed into the norm?!
Why the normal range of blood values deserves to be questioned

Standard values: Who made them – and to whom do they really apply?

There is a sentence that many people take home with them after a visit to the doctor: “Your blood values are within the normal range.” And that often means: all clear. Everything is fine. No further treatment necessary. But what exactly is this “normal range” – and whose norm is it actually?

The answer to this is less clear than we would like it to be. Behind every reference value there is a story of statistics, conventions and sometimes also tangible conflicts of interest. And anyone who knows this story begins to read laboratory values with different eyes.

How the normal range for blood values is created – a statistical construct

Most of the laboratory values that you see in your blood count are based on the so-called reference interval. It is usually calculated like this: You take a group of people who are considered “healthy”, measure a certain value in all of them and see how the results are distributed. Then you draw a line: the middle 95% of this distribution is considered “normal”, the outer 2.5% on each side is considered outside the normal range.

That sounds logical at first. But here lies the first error in reasoning: if you take 100 healthy people and apply this principle, statistically 5 of them will always fall outside the normal range – even though they are perfectly healthy. And if you test not just one, but ten or twenty values at the same time, the probability that one of them is “conspicuous” increases dramatically – even if everything is right with you.

What’s more, the group on which these values were measured is often not representative of you personally. Historically, many reference values were primarily collected from young, white, male test subjects – a problem that has only been seriously discussed in medicine in recent decades. Women, older people, people with a different genetic background, people from other climate zones – they can all have physiologically different values without this being pathological.

Who is actually “healthy” – and who decides that?

This is where a question comes into play that is rarely asked aloud, but is fundamental: who actually guarantees that these 100 people are really healthy? The honest answer is: in most cases, no one.

In practice, the reference populations are not comprehensively clinically examined. The common method is much simpler: a self-report questionnaire or a simple screening interview. Do you have a known medical condition? Do you take long-term medication? If no – then you are “healthy” in the sense of the study. That was it. No functional diagnostics, no extended laboratory, no research into personal lifestyle, sleep quality, diet or psychological stress.

This means: people with subclinical hypothyroidism that has not yet been diagnosed – healthy. People with incipient insulin resistance that has not yet manifested as diabetes – healthy. People with chronically elevated inflammation levels who are fatigued and diffusely stressed but have no official diagnosis – healthy. People with latent iron deficiency, magnesium deficiency, insufficient vitamin D supply – healthy, healthy, healthy. And these are just a few examples. All of this flows unnoticed into the calculation.

The normal range for blood values therefore does not reflect what is physiologically optimal. It reflects what is usual in an average population – in a population in which a significant proportion of people are in suboptimal health without realizing it. This is a fundamental difference that is hardly ever discussed in daily practice.

The chicken-and-egg problem: when scarcity becomes the norm

There is a certain circularity behind this that gives pause for thought. If a certain deficiency – let’s say a low ferritin value – is so widespread in the population that it appears to be “typical” in the reference group, then it is declared the normal range. And all those who have this value are considered healthy. The deficiency is thus made invisible – statistically normalized.

This phenomenon is particularly drastic when it comes to vitamin D. Studies have repeatedly shown that a large proportion of the European population has a vitamin D level that would clearly be classified as a deficiency from a functional point of view. If this population is taken as a reference, a deficiency is declared the norm without further ado – and people who would actually require treatment are told that all blood values are within the normal range.

This is not a malicious plan – it is a systemic problem. The reference value methodology was once developed to provide practical guidance. But it was never designed to be a statement of optimal health. It is a statistical reflection of the actual state – not the desirable state. Anyone who does not know this can easily be misled.

When normal values shift – sometimes with side effects

Reference values are not laws of nature. They can – and will – be adjusted. Sometimes for good reasons: because new research shows that certain values should be treated earlier. Sometimes, however, for less praiseworthy reasons.

One well-known example is the cholesterol limit. Over the decades, the “acceptable” LDL value has been revised downwards several times – which meant that millions of people who were previously considered healthy suddenly found themselves in need of treatment. Knowing that representatives of the pharmaceutical industry were also involved in the relevant guideline committees raises questions, to say the least. A new drug is launched on the market that is effective in lowering cholesterol and, coincidentally, the “standard value” of cholesterol is lowered at the same time so that everyone is in need of treatment and therefore requires the new drug….

This is not to say that such adjustments are fundamentally wrong. Sometimes it is genuine medical knowledge that leads to new limits. But it shows: Standard values are negotiable. They are man-made. And they do not apply universally to everyone in the same way.

The internal organ clock – a forgotten factor

There is another dimension that plays virtually no role in conventional laboratory medicine, although in my view it would be crucial: the timing of blood sampling in the rhythm of the body.

Anyone who has been reading my blog for a while will know that I keep coming back to the internal organ clock – the fact that each organ has its own times when it is particularly active or consciously comes to rest. The liver works most intensively in the early morning hours, the lungs reach their peak of activity in the afternoon and the kidneys are particularly active in the evening. This is not an esoteric idea, but a well-researched principle of chronobiology that has also been known in traditional Chinese medicine for thousands of years.

However, blood is taken at any time of day – in the morning at 8 a.m., at noon, in the afternoon at 3 p.m. – and then compared with the same reference values, regardless of which phase the organ in question is currently in. A liver value measured at 7 a.m., when the liver is in its most active phase, says something different than the same value in the late afternoon. A hormone level shortly after waking up reflects a different physiological reality than the same value at lunchtime. The body’s internal clock is constantly ticking – but the normal range of blood values remains the same, regardless of the hour.

What was going on just before the blood was taken?

And that’s not the end of the factors that can significantly influence a blood count without ever being included in the evaluation.

Did the person come to the practice by bike? Have they just done sports, run up the stairs, were they excited or stressed? All of this changes measurably: blood sugar, heart rate, cortisol levels, adrenaline and noradrenaline release – and subsequently numerous other values that seem to have nothing to do with exercise. Did she have a heated argument, a stressful conversation, a sleepless night shortly before losing weight? Hormones, inflammation parameters, immune values – all of these react to psychological and emotional states, often within minutes.

Did the person eat or did they appear sober? This not only changes blood sugar and triglycerides, but affects a wide range of values. And is the body silently fighting an inflammation – a subclinical one that has not yet manifested as a cold, pain or diagnosis? In this case, inflammation parameters may not be measured at all, while other values that are influenced by the inflammation appear conspicuous and lead to false conclusions.

All of this usually remains invisible. The blood count is viewed like a photo without context – without knowing what happened immediately before, what the body is currently processing, what rhythm it is in.

A laboratory value is a measured value in context – nothing more and nothing less

Anyone who thinks holistically knows that a laboratory value says nothing without the picture behind it – without the life history, sleep, diet, emotional state, genetic starting position. This applies to many values: vitamin D, thyroid parameters, blood pressure, blood sugar, homocysteine, magnesium. Wherever the normal range of blood values becomes the target for treatment, there is a risk of losing sight of the person as an individual.

Not all standards are the same – and supplementation is not always the answer

This problematic logic – an abnormal value must be brought into the normal range – is not only found in conventional medicine. Many alternative doctors, alternative practitioners and nutritionists are also trained and conditioned in such a way that a value outside the normal range is considered a problem that needs to be solved. That a person is “good” if their blood values are within the normal range. It is all too easy to forget that every person has their own norm.

This is not a theory. This is what I have observed time and again in my many years of experience as a naturopath: Values that stubbornly do not budge despite careful supplementation. Values that fluctuate without anything having changed in terms of diet or supplementation. And values that suddenly normalize – not because a new supplement has been taken, but because a psychological aspect has been addressed, an inner blockage resolved, a life issue integrated.

Supplementation can be useful. It can give the body a boost, open up a kind of new energy that you can get to know first. But staying in this new energy – that, I believe, requires a real examination of the psychological aspect behind it. The body does not supplement itself out of its patterns. It needs change on a deeper level so that what is visible on the level of laboratory values can change permanently.

What did people do in the Stone Age?

I sometimes ask myself this question – quite seriously. What did people do when there were no laboratory tests, no devices, no reference values? When the only tools were face diagnostics, observing the other person, palpating, smelling – and above all: feeling into your own body.

And then I think about what we know about people who lose one of their senses. If you go blind, your hearing sharpens. If you become deaf, your sense of touch becomes finer. The body compensates, it learns, it grows into silence and finds new ways of perceiving things there. This does not happen through effort – it happens because there is no alternative.

Wouldn’t it be the same if we learned – had to learn – to feel inside ourselves? Not once a day, but really regularly, attentively, curiously: Where does something pinch? Where does something feel heavy, tight, restless? Where is there lightness, warmth, space? If we practiced this from an early age, if there was no other option than this inner awareness, then over time we would have developed such a fine sense of our body that we would be able to sense very early on when something is out of balance – and often also what we need to make it better. The development around the topic of mindfulness represents this perspective.

Instead, we have forgotten exactly that. We no longer trust ourselves. We don’t trust our tiredness, our pain or our gut feeling – we wait for the lab results to confirm that something is wrong. Or which tells us that everything is fine, even though we have long known inside that it is not. We have given up the power of interpretation over our own body. To numbers. To reference ranges. To external confirmation.

And nowhere is this more evident than in the everyday life of modern times. Look around you: Almost everyone is now wearing a smartwatch or one of these new smart rings. And what happens? People look at their wrist in the morning to see how they slept. If the watch says: bad sleep – then a cloud hangs over them the whole day, they feel tired, exhausted, underperforming. If the watch says: good sleep – then they start the day full of energy. The same night. The same person. But the judgment comes from outside.

Why do we look at a ring/watch to know if we are tired? Why do we trust an algorithm more than our own body feeling, which actually provides us with this information in real time – free, precise, completely personal? This is not progress. It’s another stage of alienation from ourselves.

That’s not an accusation – it’s an observation. And an invitation to start again. Small, quietly, without pressure. Simply pause more often and ask: How am I doing right now – really? Not according to the clock. But according to me.

Every person has their own normal range for blood values

The next time you have a blood count in your hands, take a moment. Not to check whether you are in the green zone – but to ask yourself: How do I feel? What does this value tell me in the context of my life right now? What stage of life am I in? What has my body been through recently – physically, emotionally, mentally?

Because in my view, every person has their own normal range. And this shifts – with every stage of life, with every illness, with every growth phase, with every drastic experience. A value that was optimal for you at the age of 35 no longer has to be at 55. A value that appears conspicuous at a time of deep emotional stress can regulate itself as soon as this burden becomes lighter.

A single laboratory value is a data point – nothing more and nothing less. Only in combination with your history, your symptoms, your rhythm of life, your mental state and your genetic starting point does a picture emerge. And this picture is unique – just like you.

Integrative medicine therefore does not see laboratory values as a final verdict, but as an invitation to a conversation. A conversation between you and your body, moderated by someone who listens – not just to the numbers, but to you as a whole, at this point in time, in this phase of your life, with everything that you are at the moment.

Because health is not an average value. It is what feels right for you – now, today, in this life. So don’t be afraid if your lab results are “not within the norm”. Everything is just right in the moment.

(And a little P.S. from me as a popular example: I once took blood from myself 3 times in one day and sent these samples in to have my thyroid levels checked – all 3 results were different. So you can see the fluctuations during the day. And then you have to consider that you are normally treated for the one value that is examined. So if I had been prescribed a therapy, I would have received 3 different therapies on the same day).