“I had bloodwork done and everything was normal, or at least that’s what my doctor said.”
Sometimes, no news is taken as good news. But when you’re still feeling exhausted, anxious, or not like yourself, it’s time to ask: What are we missing?
The truth is, routine lab work is often incomplete, outdated, and based on reference ranges that don’t reflect optimal health. Add in overlooked factors like lifestyle, stress, medications, and nutrient levels, and it’s no wonder so many people feel unwell despite “normal” results.
Let’s take a closer look at what your labs might not be telling you.
1. Your Routine Bloodwork may be incomplete, and outdated.
Routine blood work panels covered by OHIP are typically minimal and do not cover all potential organ screening and nutrient levels. In fact, The College of Family Physicians of Canada does not recommend annual screening blood tests unless directly indicated by the risk profile of the patient (Choosing Wisely Canada, 2022). This means that for people who are feeling generally unwell but may not be exhibiting alarming symptoms, they may not get a chance to have blood tests done. In addition, the blood tests completed may be incomplete and missing a few other key markers that could influence symptoms such as: thyroid function (TSH, T3,T4), nutrient status (iron, B12, Vitamin D, and other vitamins and minerals).
Outdated or absent bloodwork: For many of my patients, bloodwork is either outdated (often 6 to 12 months old), or was completed at a time when they weren’t experiencing their current health concerns. With 2.5 million Ontarians currently without a family doctor, accessing even basic routine tests and screenings has become a significant challenge. As a result, individuals who feel unwell, but don’t meet the criteria for urgent care, are often overlooked. This is especially true for women navigating hormonal transitions like perimenopause, menopause, or the postpartum period, where symptoms may be dismissed or go uninvestigated.
In some cases, even when bloodwork is available, it may not provide the full picture. Further specialized testing may be necessary to uncover the root causes of persistent or unexplained symptoms. Lab tests such as comprehensive hormone bloodwork, GI-MAP stool analysis, SIBO breath tests, or sleep apnea screening can reveal imbalances and issues that routine panels often miss. These types of tests can offer deeper insights into hormonal health, gut function, or sleep quality and are especially helpful when conventional diagnostics come back “normal” but you still don’t feel like yourself. Naturopathic doctors can requisition these advanced tests and help interpret the results within the broader context of your health.
2. Your results are normal because you fall within the reference range
- Lack of population specific data: Existing ranges may not reflect the diversity of the Canadian population, leading to potential misinterpretations, especially for children, adolescents, and women.
- Reference ranges do not flag what is optimal for health. For example, a TSH (thyroid-stimulating hormone) level between 0.32–4.00 mIU/L might be “normal,” but many people feel symptomatic at levels above 2.5 mIU/L, particularly women or individuals with autoimmune predispositions.
According to the Ontario Family Physicians association, Ontario family doctors are no longer recommending physical exams and routine check ups. This is based on evidence that routine physical examinations were not reducing risk of mortality or improving early detection of conditions in the majority of the population. Your family doctor may recommend periodic exams based on your age, health risks and symptoms, but there is no standardized panel most patients will receive. The Canadian Task Force on Preventative Health Care recommends “practitioners adopt periodic preventive health visits instead of providing annual physical examinations for the delivery of preventive services.” Due to the ongoing family doctor shortage and overwhelmed clinics, routine preventive health visits are often falling through the cracks
3. The Bigger Picture Is Being Missed
Even if your lab results come back “normal,” you may still feel unwell, and there’s a reason for that.
Standard blood tests don’t assess important aspects of your daily life that can have a major impact on how you feel. Factors like chronic stress, poor sleep, low mood, alcohol use, relationship challenges, lack of movement, hormone changes, and gut health are not reflected in routine lab work. Yet each of these can significantly affect your energy, mood, and overall health.
For example, a 34 year old mother of 3 is complaining to her doctor about constant fatigue, restlessness and heart palpitations. Routine bloodwork and cardiovascular assessments have returned back normal. Upon further questioning the doctor discovers the mother has just recently returned to work after 8 months on maternity leave, and her new boss has not been accommodating. This mother is actually dealing with high stress levels, anxiety and insomnia due to challenges with work-life balance as a mother of 3. Hormone shifts post-partum can also contribute to fatigue and anxiety.
4. Common Prescription Medications May Be Part of the Problem
If your labs are coming back normal but you still aren’t feeling like yourself, it may be time to have a conversation with your doctor or pharmacist to do a medication review.
According to Statistics Canada, the most common medications prescribed are antidepressants, cholesterol lowering medications, blood pressure medications, and antacid medications (proton pump inhibitors or “PPIs”). Each drug class can have varying degrees of adverse effects that can include mood alterations, fatigue, weight gain, appetite changes and digestive upset.
For example, PPIs like dexlanprazole (Dexilant) or pantoprazol (Pantoloc), often prescribed for acid reflux or GERD, are known to impair the absorption of essential nutrients such as magnesium, B12, calcium, and iron. Over time, this can lead to symptoms like fatigue, muscle cramps, neurological disturbances, or even anemia. These symptoms can easily be misattributed to other causes, or missed altogether during routine bloodwork. Long-term use has also been associated with increased risk of fractures and changes to gut microbiome health, which can further contribute to digestive issues and immune dysregulation.
If you’ve been told your lab results are “normal” but you still don’t feel well, you’re not alone. The standard medical model often relies heavily on lab results, reference ranges, and symptom-based thresholds to flag issues, but this approach can leave many patients feeling dismissed or stuck without answers.
Whether you’re looking to support yourself or help a loved one, here are some practical next steps to consider:
1. Consider Nutrient Testing and/or Supplementation Based on Life Stage and Risk Factors
Many symptoms that fall through the cracks of conventional testing—like fatigue, brain fog, poor sleep, and mood changes—are often related to underlying nutrient imbalances. Certain nutrients are particularly important depending on your age, sex, and risk profile.
2. Track Symptoms Over Time
Sometimes patterns only emerge when we start tracking symptoms, diet, medications, sleep, and stress over a few weeks. This kind of data can be incredibly valuable for both the patient and their provider when identifying underlying drivers.
This is where a naturopathic or integrative approach can make all the difference. By looking beyond “normal” lab results and considering your whole health picture—your stress levels, sleep quality, hormonal rhythms, medication history, nutrition, and more—we can identify what’s really going on beneath the surface.
3. Build a Wellness Toolkit
While individualized care is key, there are some foundational tools that can support almost anyone feeling off:
- A Multivitamin Formula: This can help support general nutrient gaps and provide energy
- Omega 3’s: A high-quality fish oil for inflammation, mood, and cognitive support
- Magnesium Glycinate: Magnesium supports sleep, stress, muscle recovery, and digestion
- B-Complex: To support energy, cognition, and nervous system balance
- Vitamin D3 Drops: Ideal for Canadian winters, mood, and immune support
These basics can often make a surprising difference, but always consult a qualified practitioner before starting new supplements, especially if you’re on medications or have a chronic condition.
The Bottom Line
From incomplete and missed routine bloodwork, to overly broad reference ranges, to missed lifestyle and psychosocial factors, and the underestimated side effects of common medications, it’s clear that many pieces of the puzzle are often overlooked in conventional care. Symptoms like fatigue, anxiety, bloating, brain fog, and poor sleep are real, and they deserve a thorough, individualized exploration.
At NutriChem, we offer comprehensive testing and customized supplementation plans through our clinic and compounding pharmacy. If you’re unsure where to start, a free discovery call with our patient support team can help determine how we can best support you.
References
Choosing Wisely Canada. (n.d.). Health Check-Ups. Retrieved from https://choosingwiselycanada.org/pamphlet/health-check-ups/
Canadian Task Force on Preventive Health Care. (n.d.). Periodic Preventive Health Visits. Retrieved from https://canadiantaskforce.ca/guidelines/periodic-preventive-health-visits/
Ontario College of Family Physicians. (2023). New Data Shows There Are Now 2.5 Million Ontarians Without a Family Doctor. Retrieved from https://ontariofamilyphysicians.ca/news/new-data-shows-there-are-now-2-5-million-ontarians-without-a-family-doctor/
Choosing Wisely Canada. (n.d.). Family Medicine Recommendations. Retrieved from https://choosingwiselycanada.org/recommendation/family-medicine/
Canadian Association of Physician Assistants. (2023). Addressing Gaps in Primary Care Access in Canada. Retrieved from https://capa-acam.ca/_uploads/65661468c65f7.pdf
Statistics Canada. (2014). Table 4: Top 10 drug classes used by Canadians aged 6 to 79, by sex and age group, 2007 to 2011. Retrieved from https://www150.statcan.gc.ca/n1/pub/82-003-x/2014006/article/14032/tbl/tbl4-eng.htm
