'Normal' vs 'Optimal' Lab Values: Why Your Doctor and Biohackers Don't Speak the Same Language

Your doctor says your labs are normal. Biohackers say you can do better. Who's right? Decoding laboratory reference ranges.

"Your results are normal." You've probably heard this phrase. But what does "normal" really mean? And why do some health enthusiasts aim for very different values?

The Fundamental Misunderstanding

"Normal" doesn't mean "optimal." Laboratory reference values are based on population statistics — not on what's best for your long-term health.

How Are "Normal" Values Defined?

The Statistical Method

Population Sampling

The lab measures a parameter across a large sample of "apparently healthy" people.

Distribution Calculation

This produces a bell curve (normal distribution).

Defining the 'Norm'

The middle 95% are considered "normal" — the 2.5% at each extreme are "abnormal."

The Problem With This Approach

Biases in Reference Values

Non-optimal population: Samples include overweight, sedentary, stressed people
Geographic variation: Norms change by country and lab
No fine-tuning: Even same sex/age, individual needs vary
Disease threshold ≠ optimization threshold: "Not sick" doesn't equal "thriving"

If the reference population is unhealthy, being "in range" just means you're as bad off as they are.

The Biohacker "Optimal" Approach

Longevity enthusiasts don't just aim to avoid disease. They target values associated with:

Maximum longevity
Optimal cognitive performance
Sustained energy
Minimal cardiovascular risk

Concrete Examples: Normal vs Optimal

Marker	Lab Normal	Biohacker Optimal	Why
HbA1c	< 5.7%	< 5.0%	Minimize protein glycation
Vitamin D	30-100 ng/mL	60-80 ng/mL	Immunity, muscles, mood
Ferritin (M)	30-400 ng/mL	50-150 ng/mL	Avoid excess (pro-oxidant)
TSH	0.4-4.0 mIU/L	1.0-2.0 mIU/L	Optimal metabolism
hsCRP	< 3.0 mg/L	< 0.5 mg/L	Minimal inflammation
Homocysteine	< 15 µmol/L	< 7 µmol/L	Cardio + cognitive health

Case by Case: Decoded

Vitamin D: The Most Glaring Gap

Low 'normal' threshold

60-80

Optimal zone

40%+

of Americans sub-optimal

Why the Gap?

The 30 ng/mL threshold was set to prevent bone diseases (rickets, osteoporosis). But benefits for immunity, mood, and muscles require higher levels.

A level of 35 ng/mL is "normal" but may be insufficient for optimal immune function.

TSH: When "High Normal" = Suboptimal

The Thyroid Case

Typical scenario:

TSH at 3.5 mIU/L → "Normal" for the lab
But: fatigue, weight gain, feeling cold
Functional medicine: Optimal TSH between 1.0-2.0

Why? A high-normal TSH means the pituitary is "pushing" the thyroid — possible early dysfunction.

Ferritin: The Extremes Trap

Situation	Level	Problem
Too low	< 30 ng/mL	Anemia, fatigue, hair loss
"High normal" (men)	300-400 ng/mL	Oxidative stress, inflammation
Optimal	50-150 ng/mL	Iron/antioxidant balance

A man with ferritin at 350 ng/mL is "in range" but potentially in iron excess, a factor in accelerated aging.

The Conventional Medicine Position

Why Your Doctor Uses Standard Norms

The Medical Logic

System efficiency: Impossible to optimize every patient individually
Clinical evidence: Randomized trials use disease thresholds
Reimbursement: Treatments are validated for defined pathologies
Primum non nocere: Avoid over-treating or creating anxiety

Legitimate Criticisms of the Biohacker Approach

Risks of Optimization

Over-supplementation: Vitamin D at 100+ ng/mL can be toxic
Number fixation: Counterproductive stress and anxiety
Cost: Frequent tests not covered by insurance
Lack of evidence: Few studies on "optimal" ranges long-term

A Balanced Approach

When to Aim for Optimal

✓

You have symptoms despite 'normal' labs

✓

Family history of metabolic diseases

✓

Performance goals (sports, cognition)

✓

Long-term preventive approach

When Standard Norms Are Enough

✓

No symptoms, good energy

✓

No concerning family history

✓

Limited budget for tests

✓

Tendency toward health anxiety

How to Use This Information

Know Your Values

Keep a history of your labs. Trends matter more than a snapshot.

Understand Context

"Normal" means "not sick according to this parameter." Valuable but limited.

Discuss with Your Doctor

Share your goals. A good doctor will explain why they agree or disagree.

Avoid Extremes

Neither optimization paranoia nor blind ignorance of trends.

With Genki

Visualize Your Data

Genki lets you:

Import your labs from any laboratory
Compare your values to norms AND optimal ranges
Track trends over multiple years
Understand what each marker means for YOU

Final Thoughts

"
Your doctor isn't wrong to say "normal." Biohackers aren't wrong to aim for "optimal."
These are two different questions:

"Am I sick?" → Lab norms

"Can I do better?" → Optimal ranges

Both have their place.
"

— The Synthesis

The goal isn't to become obsessed with numbers. It's to understand what they really mean — and have an informed conversation with your doctor.