Normal Lab Test – NOT

One of my several brothers-in-laws told me that his A1c test (also known as the hemoglobin HbA1c) has been at 6.2 for years. (This simple, and recommended, blood test measures your sugar levels averaged over 3 months, instead of just at the precise moment of testing.) Yes, 6.2 is a tad high, but he stopped worrying about the label of “pre-diabetic,” when he repeatedly exhibited no changes or bad symptoms. It didn’t seem particularly relevant for him.

(Note for reference, the American Diabetes Association considerers “well-controlled” sugar levels are those kept around 5.6 A1c and which avoid long-term cellular damage. But keeping it below 7.0 is important for us all. Typical charts (and most doctors) generally consider the level below 6.5 to be non-diabetic. Your doc may start to use the term pre-diabetic if you reach 6.2, or somewhere between 6.0 to 6.4)

If you are like me, and most of my friends, you find yourself in discussions about health conditions. We don’t want to surrender to ‘old folk’s conversations’ that revolve only around sickness and injuries.  Nevertheless, it’s natural to turn to family and friends for feedback or just for someone to listen. Asking questions like “my doc said ‘such-and-such,’ does this seem reasonable?”

In such tête-à-têtes, we frequently banter about medical lab tests and results.  We may confide in friends about our personal ‘numbers.’  Which was high, or which low. Or worrisome. But perhaps the bantering needs some scrutiny as well – looking at a bigger picture, not just details.

What’s Normal in a Medical Laboratory Test?

I never knew (or didn’t remember) HOW “normal” was first developed for laboratory tests. Turns out, if you think about a bell curve, 2 standard deviations from the middle represent 95.45% of people. Going further out to 3 standard deviations, it represents 99.73% of people. Reference ranges are usually chosen at the 2 standard deviations point.

What does this mean? There is an accepted standard. What is typical for 95.45% of the people is supposed to be normal for you. These ranges are helpful for your doc and you to consider problems. HOWEVER, what’s typical or “normal” for you could be outside of that range.

It’s helpful if you keep your own base points over the years to know if you have “always been at that level.” If you have been, AND you have no symptoms or signs of any related conditions, it’s quite possible that the lab values showing high or low are really normal for you.

I don’t mean this as an excuse to ignore high/low lab results. It depends on the test, the level of deviation and why your test was ordered. Are you simply in the 5% of people outside “normal” for a test, or is something wrong?

BOTTOM LINE?

To share one of my long-time habits, it’s good to keep notes of your own findings on a regular basis, despite modern-day (virtual) sharing of medical records. This way you are able to provide an historical reference if you switch providers or you shift from a medical system which currently records your lab results online, but may not be compatible with another system.


Picture credit: drb

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