In Brief
Alice’s labs are “normal” but her life feels anything but—the gap between statistical ranges and functional vitality reveals a fundamental limitation in how we measure health.
Lab ranges tell us where 95% of people fall, not how you should feel on a Tuesday afternoon—they’re snapshots of populations, not blueprints for optimal function.
Alice’s “normal” numbers are actually evidence of her body working heroically to maintain the appearance of function while burning through resources to keep critical values in range.
Compensation is not free: the hidden struggle behind normal numbers shows up as non restorative sleep, weakened digestion, frayed mood, and muted energy
Alice has learned the cruel language of disclaimers—”I know my labs are normal, but...”—apologizing for feeling unwell when not “sick enough” to have abnormal tests.
Her story points toward numbers as part of a larger conversation that includes patterns, context, and lived experience rather than verdicts about health or illness.
Photo by National Cancer Institute on Unsplash The first time Alice said, “My labs are normal,” she did it with a shrug. The fifth time, she did it with a question in her eyes: “So why do I still feel like this?”
If you’ve ever been reassured by normal results while your body keeps telling a different story, you know the strange dissonance that follows. Numbers say one thing. Lived experience says another. Which one do you trust?
Alice sits in the waiting room at yet another follow-up appointment, her folder thick with lab results from the past year. Each page tells the same story: values nestled comfortably within reference ranges, check marks in all the right places, reassuring notes about “stable” and “within normal limits.” Her TSH sits at 2.1—perfectly centered in the range. Her liver enzymes have settled back to baseline. Even her inflammatory markers, which had spiked during the worst of her treatment, now hover just inside the normal zone.
On paper, Alice is a success story.
In the chair, Alice feels like she’s living someone else’s life. The brain fog that makes her lose her train of thought mid-sentence. The afternoon crashes that leave her too depleted to cook dinner. The way her hands turn ice-cold while her face flushes with sudden heat. The sleep that never seems to restore anything, leaving her more tired at 7 AM than she was at midnight.
“Everything looks good,” her endocrinologist says, sliding the lab printout across the desk. “Your numbers are right where we want them.”
Alice nods and smiles because she’s grateful for the care. She means it completely. But walking to her car, she can’t shake the feeling that somewhere between the blood draw and the results, her life got lost in translation.
This is the gap between labs and life—and it reveals something significant about how we think about health in the modern world.
The Illusion of Normal
Lab reference ranges are built to answer a specific, narrow question: among a defined population, where do most values cluster? Statistically, most ranges bracket roughly the middle 95 percent of a reference group—which means they’re excellent for flagging clear outliers and dangerous extremes.
But they don’t tell us how you should feel on a Tuesday afternoon.
The confusion starts with the word “normal” itself. When Alice’s doctor says her labs are normal, what he means is statistical: her values fall within the range where 95 percent of people land. What Alice hears is evaluative: her body is functioning as it should.
These are not the same thing.
Consider what goes into creating these ranges. Labs collect blood samples from thousands of people—mostly those considered healthy, though definitions of ‘healthy’ can vary. Some are young, some older; some on medications, some recently recovered from illness. The data are crunched, and the middle 95 percent of results are labeled ‘normal.’ But this is a statistical snapshot of a population, not a blueprint for optimal function.
This creates three fundamental problems:
Normal ≠ optimal. The midpoint of a population is not automatically the point at which you thrive. Alice’s TSH of 2.1 might be perfectly normal by population standards, but for her particular body, with her particular history, it might not be the sweet spot where she feels most herself.
Normal ≠ stable. A number can sit “in range” while trending in a concerning direction over time. Alice’s inflammatory markers have been creeping upward for months, but because they haven’t crossed the threshold into “abnormal,” the trend gets overlooked.
Normal ≠ context. The same number can mean different things in different bodies and different seasons of life. A fasting glucose of 95 might be unremarkable for a sedentary 50-year-old, but concerning for an athlete in their twenties.
Ranges are tools, and like all tools, they shine when used for their intended job and mislead when used for everything else.
The Hidden Struggle Behind Normal Numbers
To understand why Alice can feel terrible while looking great on paper, we need to understand how the body maintains those numbers in the first place.
As we explored in our discussion of balance, the body maintains stability through allostasis—the dynamic process of “stability through change.” For Alice, this system has been working overtime since her diagnosis, maintaining normal-looking lab values despite the extraordinary challenges of cancer treatment.
But compensation is not free.
The cost shows up as allostatic load—the accumulated wear and tear we examined earlier. Your body can hold things together on paper while your experience registers the strain: sleep becomes unrefreshing, digestion weakens, mood frays, energy flattens.
Alice’s “normal” labs are actually evidence of her body working heroically to maintain the appearance of function. She looks fine on paper because her systems are burning through resources to keep critical numbers in range. By the time a lab value finally tips out of range, the person may have felt unwell for months or years.
This is why Alice can have perfect TSH levels while feeling cold and exhausted. Her thyroid medication is providing enough hormone to satisfy the blood test, but her body’s ability to convert and use that hormone efficiently has been compromised by the accumulated stress of treatment and recovery. The feedback loop between her brain and thyroid works well enough to maintain “normal” TSH but not well enough to make her feel warm and energetic.
Alice’s Daily Reality vs. Her Lab Results
Alice’s “normal” numbers tell a story that diverges dramatically from her lived experience. Take her cortisol levels—they may test within normal range, but the timing for her is all wrong, peaking anxiously at 4:30 AM instead of rising gently with dawn. Her blood sugar sits at a perfectly normal 88, yet her brain feels starved of fuel. After lunch, her glucose stays within healthy limits while her body shakes with fatigue, working overtime to manage what should be a routine metabolic task.
Each moment of struggle coexists with numbers that would reassure any doctor. Alice isn’t making it up, and she’s not being dramatic. She’s living in the gap between statistical normal and functional optimal.
The Language of Struggle Without a Diagnosis
Alice has learned to speak a new language—the language of people whose suffering doesn’t show up in tests. She’s become an expert in disclaimers:
“I know my labs are normal, but...”
“I don’t want to complain, because technically everything looks fine, but...”
“I’m sure it’s nothing serious, since all my tests are normal, but...”
These disclaimers reveal something heartbreaking: Alice has internalized the message that if her numbers are normal, her experience doesn’t count. She’s learned to apologize for feeling unwell when she’s not “sick enough” to have abnormal labs.
This is the cruelest aspect of the normal-labs-abnormal-life dilemma. It’s not just that medicine can’t fix the problem—it’s that medicine often can’t even see the problem. Alice finds herself in a strange medical purgatory: too sick to feel well, too “normal” to be sick.
Her symptoms get treated as separate, unrelated issues. Fatigue gets attributed to depression and treated with antidepressants. Brain fog gets dismissed as stress. Sleep problems get addressed with sleep hygiene recommendations. The neuropathy gets managed with gabapentin. Each symptom is handled in isolation, by different specialists, without anyone asking whether they might all be manifestations of a deeper pattern.
Where “Normal” Becomes Dangerous
The fixation on normal ranges doesn’t just fail to capture Alice’s experience—it can actively work against her healing. When doctors focus primarily on moving lab values into normal ranges, they can miss the forest for the trees.
Alice’s thyroid provides a perfect example. Her TSH of 2.1 is normal, so her dose stays the same. But TSH is just one piece of a complex system. Her body might be struggling to convert T4 to active T3, or her cells might be having trouble using the thyroid hormone that’s available. These subtleties don’t show up in standard thyroid tests, so they don’t get addressed. Meanwhile, Alice continues to feel cold, tired, and foggy.
The same pattern repeats across her care. Her inflammatory markers are normal, so the smoldering inflammation that’s driving her joint pain and brain fog goes unaddressed. Her fasting blood sugar is normal, so the insulin resistance that’s making her feel shaky and tired after meals gets overlooked.
“Normal” becomes a stop sign rather than a starting point for deeper investigation.
The Missing Context
What Alice’s labs can’t capture is context—the story of how her particular body, with its particular history, in its particular environment, is trying to function. Her “normal” cortisol might actually be elevated for her baseline, based on what her levels were before cancer. Her symptoms follow patterns related to sleep, stress, and meal timing that don’t show up in static lab values—patterns that reveal the dynamic interplay between her thyroid medication and her other drugs, her meal timing, and her sleep quality. The seasonal variations in how she feels suggest her system has become more sensitive to environmental changes than it used to be, while the cumulative impact of multiple medications affects how her liver processes everything from hormones to nutrients.
A single blood draw captures a moment in time, but Alice’s experience unfolds across hours, days, and seasons. Her body tells a story of adaptation and struggle that numbers alone cannot reveal.
The Trap of Chasing Perfect Numbers
Alice has begun to wonder whether the focus on normal labs might actually be preventing her recovery. She’s seen specialists adjust medications to optimize her numbers while her symptoms persist or even worsen. Her endocrinologist increases her thyroid dose to bring her TSH down, but she feels more anxious and jittery, not more energetic. Her rheumatologist celebrates her inflammatory markers dropping into the normal range, but her joint pain continues unchanged.
This creates a frustrating paradox: the harder the medical system works to normalize her labs, the more disconnected her care becomes from her lived experience.
Alice begins to suspect that she’s been asking the wrong question. Instead of “How do I get my numbers normal?” maybe the question should be “How do I help my body remember how to function?”
But that’s not a question that lab ranges can always answer.
When Numbers and Narratives Diverge
Alice’s story reveals the fundamental limitation of using lab ranges as the primary measure of health: they tell us about statistical position, not functional capacity. They can tell us whether someone is likely to have a diagnosable disease, but they can’t tell us whether someone has the vitality to thrive. They have real utility, and also real limitations.
This matters because Alice doesn’t want to just avoid disease—she wants her life back. She wants to wake up feeling rested, to think clearly during afternoon meetings, to have energy left over for the people and activities she loves. She wants her body to feel like home again, not like a foreign country where she doesn’t speak the language.
These goals require a different kind of measurement—one that pays attention to patterns, trends, and the dynamic interplay between systems. One that values the person’s experience as much as their lab values.
The Path Forward: Numbers as Part of a Larger Story
Alice’s experience points toward a different way of thinking about lab results—not as verdicts about health or illness, but as pieces of a larger puzzle that includes her symptoms, her patterns, her context, and her goals.
This doesn’t mean throwing out lab ranges or ignoring medical science. Alice’s clear scans are genuinely reassuring, and dangerous lab abnormalities would absolutely need immediate attention. But it means holding lab results lightly, as part of a conversation rather than the final word.
Some numbers are non-negotiable. If her labs showed dangerous derangements like extreme electrolyte imbalances, severe anemia, or liver enzyme elevations suggesting drug toxicity, those would need immediate intervention.
But for the subtler struggles that characterize Alice’s daily experience, lab literacy becomes more important than lab optimization. The goal shifts from getting every number into the normal range to understanding what the numbers mean in the context of her life.
Alice’s story challenges us to think differently about what “healthy” means. Is health the absence of abnormal lab values? Or is it the presence of vitality, resilience, and the capacity to engage fully with life? Her labs suggest the former; her daily experience argues for the latter.
What Comes Next
Alice’s struggle with normal labs that don’t reflect her abnormal experience points to a larger problem in how we approach health and healing. Her various symptoms—fatigue, brain fog, sleep problems, digestive issues, temperature dysregulation—are being treated as separate, isolated problems. But what if they’re not?
What if Alice’s constellation of symptoms represents not a collection of unrelated issues, but a pattern—a systemic dysfunction that can’t be captured by looking at individual lab values or addressing individual symptoms?
In our next exploration, we’ll zoom the camera out to examine why treating symptoms one by one often fails to create lasting change, and how systems thinking might offer a different path forward. Because Alice’s story suggests that the problem isn’t just how we interpret lab results—it’s how we think about the body itself.
Her labs are normal. Her life is not. The gap between these two realities reveals something profound about the limits of our current approach to health—and points toward the need for a more complete understanding of what it means to heal.
