The Truth About “Normal” Labs: Why You Still Feel Like Crap

If you’ve been told your labs are “normal” but you still feel exhausted, bloated, brain-fogged, or just off—you’re not imagining things.

This is one of the most common frustrations I hear from women, especially those with Hashimoto’s, hormone issues, or autoimmune disease.

In functional nutrition, we don’t settle for “normal.” We look for what’s optimal—because that’s where healing happens.

🧪 Normal vs. Optimal: What’s the Difference?

Traditional labs report results based on reference ranges, statistical averages of the population.
But here's the problem:

• These ranges include sick or symptomatic people

• They’re often too broad to detect early dysfunction

• Just being “in range” doesn’t mean your body is functioning well

👩‍⚕️ Optimal ranges, by contrast, reflect what’s needed for vibrant health, energy, hormone balance, and longevity.

“Normal” means surviving.
“Optimal” means thriving.

🔍 Thyroid Labs: What to Ask For (and What the Numbers Should Really Look Like)

If you have Hashimoto’s or hypothyroid symptoms, a full thyroid panel is essential—not just TSH.

Here’s what I recommend running; and the optimal functional ranges from the Functional Nutrition Alliance (FxNA):

• TSH: 0.5 – 2.0 μIU/mL
  → Higher values often signal sluggish thyroid function

• Free T4: 1.1 – 1.5 ng/dL
  → Shows how much inactive hormone your thyroid is producing

• Free T3: 3.2 – 4.2 pg/mL
  → This is the active thyroid hormone your cells use for energy

• Reverse T3 (rT3): Less than 15 ng/dL
  → Elevated rT3 can block Free T3 from working

• TPO Antibodies: Less than 15 IU/mL
  → Higher levels mean your immune system is attacking the thyroid

• TG Antibodies: Less than 1 IU/mL
  → Another sign of thyroid autoimmunity

📝 Even with a “normal” TSH, many women feel awful when Free T3 is low or Reverse T3 is high. This is why a full panel truly matters.

🔋 Iron + Ferritin: The Fatigue Connection

Iron is about more than anemia. It’s essential for energy, mood, metabolism, and oxygen delivery.

But too often, only serum iron is checked—and that doesn’t give the full picture.

Here’s what I run and the optimal ranges I look for:

• Ferritin (iron storage): 70–150 ng/mL for women
  → Below 50 = fatigue, hair loss, low thyroid conversion

• Serum Iron: 85–130 μg/dL
  → Reflects circulating iron in your blood

• Iron Saturation: 25–35%
  → Shows how well your body is utilizing iron

• TIBC (Total Iron Binding Capacity): 250–350 μg/dL
  → High = deficiency; Low = inflammation or iron overload

• Transferrin Saturation: 30–40%
  → Helps determine true iron availability

🥄 If your ferritin is 10 or 20, that’s not “a little low”, that’s “you’re going to feel like a zombie” low.

💡 So What Can You Do?

Let’s turn lab confusion into healing clarity:

✅ Step 1: Ask for the Right Labs

• Full thyroid panel (TSH, Free T3, Free T4, rT3, antibodies)

• Comprehensive iron panel (including ferritin, TIBC, saturation)

• Vitamin D, B12, homocysteine, and CRP

• Sex hormones (depending on symptoms and age)

✅ Step 2: Use Optimal Ranges

• Don’t settle for “in range” if you’re still symptomatic

• Work with someone (like me!) trained in functional ranges

✅ Step 3: Combine Data + Symptoms

• Labs are important, but so are your symptoms

• Your body is talking—learn to listen to it

You’re Not Crazy—You’re Just Not Getting the Full Picture

If your doctor says everything looks fine, but your body says otherwise—it’s time to dig deeper.

Root cause healing begins when we move past surface level results and actually listen to what your labs, symptoms, and story are telling us.

You deserve answers.
You deserve to feel good.
And you’re not alone anymore.