I recently suggested to a client that he add a few additional items to his upcoming lab tests. The doctor had no idea what SHBG was, couldn't find Estradiol on the requisition list, and was confused as to why anyone would even want to know this stuff. Since I started incorporating lab testing with cleints on a regular basis several years ago, I've had the opportunity to review hundreds of results, make changes in lifestyle, nutrition, exercise and supplementation, then reevaluate labs several months later. I've learned a lot during this time, and consider lab testing to be of tremendous value. And about 80% of the time, I end up with stories like the one I just told regarding conversations with doctors.
Nutrition Coaches and RD's are typically looking at lab testing results in a completely different way than doctors. It's not that we're right and they're wrong, moreso that they're trying to do their jobs and we're trying to do ours. In a perfect world, a client gets both people working together to come up with specific recommendations that wouldn't have surfaced with just one or the other. I love it when this happens.
Unfortunately most docs are dismissive of the role of a Nutrition Coach in looking at labs. They just want to run basic tests, and if you fall out of the reference range then they will likely write a few prescriptions and tell you to eat less fat and jog more.
This quick video from Bryan Walsh does a great job of explaining why these reference ranges may not be as useful as they are made out to be by your doc (and why NC's and RD's use different ranges).
In addition to reference ranges being pretty questionable, with regards to achieving optimal health, standard labs are typically quite incomplete if you really want to uncover some underlying issues.
For example, if I want to know about a client's thyroid health, I'm going to look at five or six blood markers whereas typically a doctor would look at two or three. If they see something out of their reference range on the abbreviated test, you walk out with a script for Synthroid and a pat on the ass.
Sometimes prescriptions are necessary, and a great idea. But often you end up taking a medication that is just treating symptoms and not addressing the real problem. So what to do? Find a doc that is willing to have an open dialogue with you about your optimal health, and sees the value in working with you AND your Nutrition Coach or RD, as a team.