I woke up this morning to this email from my husband: “I’m just outside of Normal.”  He meant Normal, Illinois, where he’s traveling for business.  But his note could have just as easily referenced how many of us feel about our health.  Lab tests come back “normal,” or just outside, but we still don’t feel well. 

What’s to be done?  In this guest post, integrative physician and friend of Fresh Living Dr. Shilpa Saxena explains a concept she uses in her practice: “The Walking Unwell.”  Read on to learn whether you fit this category, why lab-feeling discrepancies are so common, and what you can do to emerge into wellness.Holly

“The Walking Unwell”

By Dr. Shilpa Saxena

in medical training, a physician learns that
there are many ways to gather information related to a patient’s
illness.  As eager detectives, we search for the source of the
problem.   We can ask the patient to describe their symptoms, the
timing of when they began, if anything makes them better or worse.  We can
look closely at them, listen to bodily functions, palpate or feel for a
problem.  Ultimately, in the course of our investigation, we find
ourselves ordering laboratory tests.  If the results confirm our suspicions of the source of the
problem, BINGO, we’re on track.  However,
very often the results are “normal.”  So, what does
this mean about your symptoms?

is a popular misconception that the values that run down the far right side of
your lab reports determine if you are normal or abnormal.  Actually, if
you look closer, you will see the column heading will read,
“Expected” or “Reference Range.”  Why
doesn’t it just say “Normal?”  Well, because there really is no
such thing!  When Reference Ranges are established, patients
with varying age, sex, race, diet, medications,
stress levels, and many other factors are sampled.  If, for example, samples are
collected on someone who doesn’t know they have liver problems from their
“normal” alcohol use, that value is still included to calculate the Reference Range. 

Because of this, Reference Ranges include many values that could still be
“abnormal” or more precisely, unhealthy.  These types of
results widen the reference range.  So if your numbers fall inside the
Reference Range, it only means that you are in the range of 90% of the people
that were sampled.  And unfortunately, these days, I wouldn’t say that
if you are like 90% of the American public, you are optimally healthy or
“normal” in terms of body function.

other consideration is that while we are all human, there is such a tremendous
degree of variability among us.  When we factor in diet, level of
exercise, social activities, sleep, stress levels, and genetics, one
person’s feeling “great” is another person’s “sick.” 

A very simple example is with vitamin B-12
levels.  Most of us recognize B-12 as “the energy
vitamin.”  The clinical Reference Range for this lab is 200-1100 pmol/L.  In my practice, I routinely witness
patients who feel chronically exhausted when their values are around 500
pmol/L, yet I have other patients that are full of energy with B-12 results of
350 pmol/L. 

So where does that leave you if you feel bad but are still “in range?” That puts you into a category that I call The Walking Unwell.  The Walking Unwell live between
the zones of being Optimally Well and Obviously Diseased, and they make up the
majority of patients. 

If you intuitively know
something is off yet the conventional medical system has not yet determined the what,
why and how these symptoms came to exist in you, it could be because the
current system of healthcare was not designed to focus on and treat
your issues.  Modern medicine is so good at fixing problems with
surgical procedures and prescription drugs–problems like broken bones,
ruptured gallbladders, and infected lungs.  These are called acute medical

But chronic diseases that develop over years, like diabetes, high
blood pressure, and long-standing digestive disorders, do not “correct” with this conventional
approach–and these chronic diseases are often in the mix for The Walking Unwell.  The current healthcare model “treats” diseases, but I believe that
long-term health lies in understanding that
we need to fix the root causes of those disease.  

So, where does that
leave you?

answer is simple, and it starts with understanding that people aren’t
healthy one day and chronically diseased the
next.  Poor health is more often the gradual progression of a problem (or dysfunction) that at some point just tips over into where your labs look

But long-term health is attainable, and often taking a close look at your lifestyle is the roadmap to attaining it.  What I’ve found most of the time is that The Walking Unwell have
lifestyles that are not conducive to living long, healthy, vibrant lives. 
Instead, because of daily poor food choices, lack of movement, or poor stress
management, Walking Unwell patients develop issues that they suffer with needlessly. 

So my advice is, don’t wait for your labs to fall outside the Reference Range
before you decide to make a change.  Your body talks to you
every day.  Listen to it and start treating it well
with whole, nutritious food, energizing movement, and time for relaxation every day.  Then, relish
the joy of being able to walk, jog, or run
right out of The Walking Unwell zone!

Learn more about Dr. Saxena at, and join her wellness community on Facebook at

More from Dr. Saxena on Fresh Living:

Why Whole Grains Feel So Good

Asparagus: What’s That Smell?

(image via:

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