Normal vs Optimal: Understanding Blood Test Results Through an Integrative Health Lens
By Dr Ala Farah
General Practitioner | Co-Founder and Medical Director
If you’ve ever had blood tests done and been told that “everything looks normal,” yet you still don’t feel well, you’re not alone.
In clinical practice, I often meet women who are doing many of the right things - eating well, exercising, managing stress - but still feel tired, foggy, hormonally unsettled, or simply not themselves.
One of the reasons this can happen lies in how blood test results are interpreted.
This isn’t about right or wrong.
It’s about different lenses, different goals, and different questions being asked.
What Does “Normal” Actually Mean?
When your GP orders blood tests, your results are compared against a reference range.
These ranges are developed by testing large populations and identifying where the middle 95% of results fall.
In simple terms:
“Normal” means statistically common.
It does not always mean optimal for energy, resilience, or symptom relief.
GPs are trained to:
identify disease
rule out serious pathology
manage acute and chronic illness
And they do this exceptionally well.
Their priority is determining whether a result indicates a medical condition that requires treatment or further investigation.
If your values fall within the reference range, they are often considered reassuring from a conventional medical perspective - and in many cases, that reassurance is entirely appropriate.
The Integrative Perspective: Looking Beyond Disease Thresholds
In integrative and lifestyle-focused care, we often ask a slightly different question:
“Is this value supporting how this person wants to feel and function?”
Rather than focusing only on disease thresholds, this approach looks at patterns, trends, and context - particularly when symptoms are present.
This may include considering whether results are supporting:
stable energy levels
hormonal balance
metabolic health
cognitive clarity
long-term wellbeing
This does not mean the result is abnormal.
It simply means there may be room for further optimisation or investigation, depending on the individual situation.
In clinical practice, this often involves looking at the whole picture - symptoms, history, lifestyle, and trends over time - rather than relying on a single number in isolation.
Why This Matters - Particularly for Women
Women’s physiology is dynamic and responsive to life stages.
Hormones shift across:
the menstrual cycle
pregnancy and postpartum
perimenopause
menopause
They are also influenced by:
sleep
stress
nutrition
workload
emotional demands
Standard reference ranges are designed for population safety.
They are not always tailored to individual life stages, symptom patterns, or functional goals.
As a result, it’s not uncommon to hear:
“My iron is normal” - yet energy remains low
“My thyroid is normal” - yet fatigue or weight changes persist
“My hormones are normal” - yet PMS or sleep disruption continues
In some cases, a more detailed review of results - alongside symptoms - can help identify patterns that deserve further attention.
An Analogy: The Fuel Gauge
I often explain this using a simple analogy.
Think of your body like a car.
A GP might say:
“You’re not empty - you can still drive.”
An integrative clinician might say:
“You’re running low - let’s refuel before problems develop.”
Both perspectives are valid.
They simply focus on different stages along the health continuum.
Working Alongside Your GP - Not Instead of Them
At Cellara, we deeply respect GPs and the essential role they play in healthcare.
Integrative care is not about replacing conventional medicine.
It is about working alongside it.
Think of it as:
GP care
Focused on diagnosis, safety, and treatment of medical conditions
Integrative care
Focused on prevention, optimisation, and understanding contributing factors
Many people continue seeing their GP while also seeking additional support to better understand:
nutrient status
hormonal patterns
metabolic health
lifestyle and stress factors
This collaborative approach is often where the most meaningful progress happens.
If You’ve Been Told “Everything Is Normal” - But You Don’t Feel Normal
Your symptoms are real.
Your experience matters.
And sometimes, the answers live between the lines of standard reference ranges.
A thoughtful review of results - combined with clinical assessment - can help identify areas that may benefit from early attention.
At Cellara, our goal is simple:
Healthcare should help you feel not just reassured - but supported.
