The Good and Bad of Blood Markers
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Unravel the significance of blood markers with insights from Dr. Rutherford. Discover how crucial blood panel analysis is and why simply relying on the “normal” label might be misleading. Learn how inconsistencies in lab ranges and the way doctors interpret results can impact diagnosis and patient care.

Martin P. Rutherford, DC
1175 Harvard Way
Reno, NV 89502
775 329-4402
#drmartinrutherford #BloodMarkers #BloodPanels #LabRanges #Diagnosis #PatientCare #Healthcare #LabNumbers #Inflammation #VitaminD #Homocysteine

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So the question is, the good and bad of blood 
markers. So I'm trying to think about that because   There's a lot of things I'd like to say about 
blood markers. Because when I get a blood panel,   I sit down and our blood panels are long, but 
I sit down for, sometimes I'm 20, 30 minutes   Looking at a blood panel. And there's a story 
in those numbers. And I must say, classically   I've been to doctors and I've followed doctors 
and I have patients who've been to doctors lots,   And the doctor basically kind of glances at it. 
I know doctors, this probably isn't all of you,   But it's all the ones I've met so far. And they 
kind of glance at it and there's a column on the   Blood panels that says marker [inaudible 00:00:59] 
says, and they just kind of glance down and just   Look for that one column to see if the lab has 
told them that the marker is normal or not.  And let's say you have a vitamin D level of 
30.1. That won't show up as abnormal because   The range is 30 to 100. But 30.1 is kind of low 
and I'm going to look at that and go, you know,   You got low vitamin D. Whereas somebody just 
looks at those, that column that just tells them   Normal abnormal, normal, abnormal, 
and then they look at the abnormals.   That's not the way you're supposed 
to look at blood panels at all.  So the good and bad blood panels. So the good, 
there's a lot of good in blood panels, especially   If you're good at reading them, if you've 
taken the time to understand what each   Blood marker means or what it can means. 
And if you take the time to look at how,   Maybe … I'll give you a good example, how 
maybe blood panels are associated with each   Other. Somebody comes into the office and 
they have symptoms of pre-diabetes. They're   Falling asleep after meals. They're putting away 
for no reason at all. They're urinating five times   A night and so on and other things. And they have 
all these symptoms. And then you look at the blood   Panels and their A1C, which is the gold standard 
in the medical model for blood sugar, is normal.   Maybe it's high normal, but it's 
normal. They're done. That's it.  If that person has all the symptoms of it, then 
you should know, and I must say there's just a lot   Of people who don't know, to look further. Maybe 
next thing you should look at is the lipid panel.   Why would I look at the fat panel? 
Because seven to 10 years before   Your blood panels show pre-diabetes, your 
triglycerides will go up, not your cholesterol,   Not your low density, your triglycerides will 
go up. If your triglycerides are equal to   Or greater than your cholesterol and you 
have pre-diabetic symptoms you should treat   For pre-diabetic because not only are you 
getting the symptoms, but you're getting the   Inflammation. You're getting the inflammation in 
the arteries and the brain and so on and so forth.   So is that the bad or the good 
part of lab numbers, of lab ranges?  So the basics on lab range are this: each lab 
range is affected by the lab that you go to. So   Each lab has a patient population. So if you go 
to Beverly Hills or if you go to the Ghetto in  

Central Chicago, now I lived in Chicago and I was 
in an internship in the Ghetto, so I can say that,   Okay, don't cancel me or anything like that. 
These are different populations. All right? And   You're going to get different numbers from people 
who are eating, maybe they're eating too richly,   Maybe they're going to be overweight, or maybe 
they're running on treadmills or stuff like that,   Versus the people in the ghetto who maybe are 
suspect of having, in a ghetto, of having a   More difficult life, maybe having a little 
bit more difficulty, maybe eating fast foods,   Maybe not eating that type of stuff. 
Their labs are going to look different.  The lab range in that, and I grew up in a minimum 
wage neighborhood, so we could use that too,   The lab range in that neighborhood are going 
to be different than the lab ranges in the   Wealthier neighborhood. And so what they do 
is to make the lab ranges for that lab, they   Take a bell curve of all the people in that lab. 
They cut off the ends and then that's their norm.   Lately, so there's a lab number, there's a 
lab marker called homocysteine. I'm going   To use this for an example because this 
is a perfect example for this question.   What is the good of this marker? If you know how 
to read this marker, you know that maybe this   Person doesn't process their vitamins properly, 
their B vitamins properly, you know that maybe   Their liver's not detoxing properly, you know 
that there's an inflammatory response going on   Primarily in their brain and their nervous system.
You can know all that if that this lab is normal   Or not normal. Okay, how do you know that 
though? Because right now I don't know what's   Going on with homocysteine out there, all 
you guys in the labs, but the ranges can be   Zero to 6.7. So over 6.7 means the person's 
got high homocysteine, they're not bringing   Down their B vitamins. If the person's coming 
in here with brain fog, mental fog, anxiety,   Things of that nature, short temper, that could 
be a big finding. So that finding would be,   Except I just saw one yesterday with a lab range 
of 21. So you got to be over 21 there. So in their   Lab everybody between 6.7 and 21 is normal and 
they may be running around with shaky, anxiety,   Tremors, they may be running around with brain 
fog, mental disturbances of their serotonin or   Dopamine. They may be told they're normal.
What is the normal range? I don't know.   I use the lowest one because that's the safest 
one for me because I'm going to be giving them   B vitamins or B6 or B12 or something that, 
but I have also seen in the last six months,   Those of you out here at lab techs, I 
have seen the range for homocysteine be   Eight for at the low end. I've seen it be 
14, I've seen it be 12. I've seen it be   16. I had another one last week that was 
16. I've only seen one in the twenties.   So that's the downside of lab ranges.
Hashimoto's thyroid disease, which I   Treat a ton of, in the beginning when 
I started, the range was zero to 100.   Some of my colleagues who were doing research on 
this said it should be zero to nine, so we use  

Zero to nine because it seemed to make more sense 
because we had a lot of people who were like 60   And they had all the symptoms of Hashimoto's 
and they were being told they were normal.  Now it's come down to, in my town, so I'm in 
Reno, Nevada, so there's one hospital here,   The range is zero to nine, there's another 
hospital here, the range is zero to   34 and there's another hospital 
here, the range is zero to 32.   So how about all those people between nine and 
32 and 34? Who's right? I use zero to nine.   I believe the Mayo Clinic uses zero to nine, 
but you can check me on that. But that's what   I've heard lately. But zero to nine is probably 
the right number just based on what I see when   You look at people's symptoms, their exam 
findings versus that. There I do patients   From all over the United States, all over the 
globe, in places in Alabama and Mississippi,   The range is still zero to 100. And I have seen 
those labs in as recently as the past year. In   Georgia, in Southern Georgia too. I've seen them 
them real high down in Southern Georgia and I've   Seen a few areas where it's still like zero to 50.
So the downside of lab ranges is they're   Mind-bogglingly inconsistent. So to 
make the lab range more meaningful,   I always use the narrowest ranges because that way 
I'm just sure I'm not missing anything. But then   You have to, so here's the downside to 
lab ranges, the downside to lab ranges,   What I was just going to say is the next thing you 
need to do is you then need to go and do a history   And an exam on a person and see if their history 
and their exam findings are going to fit that.  If you're got, and this is not to blame 
the doctors. I am in full sympathy with   The doctors. I mean, if you got 10 or 15 
minutes with a patient, and you're going to   See six patients an hour and stuff like that. And 
that's what it's like around here, an awful lot.   Well, you're not going to do any of that. In 
fact, you're not going to look to see if it's 30.1   In a range of 30 to 100 and give the person 
vitamin D, because you're not even looking at   Those numbers. You're just looking at the flag 
column that's says, no, everything's normal.   Everything's normal. It's 30.1. It's normal. 
Person's got symptoms of low vitamin D,   But you're not going to give it 
to them because it's in the normal   Range and nobody's looked at the normal range.
So that's a problem. And I'm going to say I'm   Getting up there in age a little bit. And when I 
learned diagnosis, it was in the seventies, early,   Mid-seventies, mid-seventies. And back then we 
were taught, you do a history, you do an exam,   Then you come up with your differential diagnosis, 
meaning the top three things you think it is,   In the order of the importance of the way you 
think it is, and then you do labs in attempt to   Confirm that. You don't just do a bunch of labs 
to see if it's going to tell you what's going on.  Because by the time you've 
done a history and exam,   You should pretty much know what's going on most 
of the time, maybe not all the time, but probably  

90% of the time or more. And then a lot of doctors 
are going to say, "Oh, he's stupid. He doesn't   …" No, because they don't do this anymore. I'm 
not being mean, I'm just saying this is how it is.   So now you do that, and then the lab says yes 
or no, and then you go, well, the lab says no,   But this all says yes, the diagnostics, the 
history, the exam. So you treat them for the   Diagnostic histories. That was normal procedure 
up until probably like the nineties. That was   Normal. Now we got so many tests and so many 
people making money off of tests and all that   Type of stuff. I mean I think it's part of it.
But then we got the doctor who looks at the   Test and says, no, you don't have it. No, your 
antibodies are down today. No, you don't have the   Antibodies for Hashimoto's. Maybe it's an off day. 
That's another thing. You can take a lab in the   Morning. I've had people come in here, take a lab 
in the morning, have one set of numbers, and then   Something happened where they weren't feeling so 
good. They went to the hospital in the afternoon,   Did another set of labs and you wouldn't know it 
was the same person. Now part of it was maybe they   Developed a viral infection, maybe they're in an 
accident. But even the other numbers that wouldn't   [inaudible 00:13:04] in that, would be different. 
So the downside of labs is it's a snapshot.   It is a snapshot. Some things are going 
to be more consistent than others and   Some are going to be more unstable than others.
The glucose is so unstable. If you take a stick   Of gum on the way to getting your blood taken, it 
could go up and down 40 points. And most doctors   Are aware of that. But a lot of the other ones, 
a lot of doctors aren't aware of how if somebody,   I just had a person come in last week and their 
SGOT and their SGPT were off the charts. These   Are two liver markers and if they're high, 
you got to start looking elsewhere to try   To figure out do they have a cirrhosis of 
a liver? Do they have fatty liver? What do   They have? They have alcoholic liver, what do 
they got? Well, this patient has nothing else.  They said, "Well, I was at a doctor, he said, 
I got a fatty liver and I got to start taking   This drug and that drug." And I said, "Do you 
exercise?" "Yeah." "Do you exercise hard? Do   You like do high intensity exercise and all that 
type of stuff?" I didn't mean to make fun of that.   I've done high intensity exercising. And she said, 
yeah. I said, "Did you do it the night before you   Went to the lab?" She says, "I did it the morning 
before I went to the lab." That will raise those   Two markers. She was probably normal.
So what are the positives of lab ranges   And labs? The positives are we have them. The 
negative is there's a lot to them and we either   Don't take, as a healthcare professional today, 
there's a lot of confusion on them. The ranges   Differ. A lot of times we don't take enough time 
to figure out what the lab ranges really look   Like. Sometimes we just look at the flags column 
and we don't really look at the numbers to see   If they're borderline high, borderline low, and if 
those numbers fit with the exam that we didn't do.  That's the up and down of lab ranges and lab 
numbers. And it's kind of a commentary on that's  

Kind of the ups and downs of the 
way we do diagnosis today. So   I think that's the best answer that 
I can give you on that question.