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Today we will begin to discuss how the spectrum which medicine currently considers “normal” may not actually be optimal towards your overall health and wellness. These reference ranges can change based on age, gender, physical activity, and more. As a matter of fact, if we were to evaluate an individual’s weight in the United States, it would be considered “normal” to be overweight, simply because 70 percent of the population is overweight. Reference ranges for lab tests today are based on a sick population when we should aspire for optimal well-being.
Then, I will demonstrate how this knowledge can apply to the most basic medical measurements: your vital signs. Everyone knows that when you first visit a doctor, they take your vital signs, including your weight, your blood pressure, your heart rate, and your temperature. However, does your doctor tell you what your results mean? How can you tell if you’re healthy?
Hello everyone, it’s Dr. Alex Jimenez. Welcome to part 2 of “Taking Control of Your Healthcare”. Today, we will discuss laboratory reference ranges associated with your vital signs. It may not sound like an interesting topic, but it’s really important for your well-being.
Most doctors generally define a patient’s test results as either “normal” or “abnormal”. But what exactly does “normal” and “abnormal” mean? Normal is when 95 percent of the population falls within a common range while abnormal is when the remaining percent of the population falls outside that common range. Whether you’re healthy or sick, young or old, although there can be some variations for children, normal and abnormal are simply statistical numbers which fall within two standard deviations.
However, these standard deviations don’t necessarily mean it’s optimal or not. It’s only a statistical number, after all. As a matter of fact, disease can occur along healthy and unhealthy individuals. These lab reference ranges should be defined according to what is best for a human being.
By way of instance, vitamin D levels are classified as normal if they’re over 20, however, the ideal levels are over 50. So why is 20 considered “normal”? This is because approximately 80 percent of the population is deficient in vitamin D, therefore, they fall under what is considered to be the “normal” range. However, this doesn’t mean that these levels are best for your overall health and wellness. Furthermore, “normal” blood sugar levels have been classified to be under 100, although we know “optimal” blood sugar levels have been classified to be between 70 to 80. Blood sugar levels over 80 can have an increased risk of disease. And unfortunately, our “normal” laboratory reference ranges are not optimal because we’ve become a sick population. In the United States it can be considered “normal” to be overweight because 70 percent of our population is overweight. But, although being overweight or obese is considered normal in the United States, that’s not something we would want to aspire to. We want to aspire to achieve overall health and wellness.
Now let’s continue to discuss the meaning of normal. Many patients often visit the doctor only to be told that their lab tests have returned normal, however, they may still be feeling sick. What does that mean? Does it mean you’re sick? Does it mean you’re healthy? As I’ve mentioned previously, either your doctor is missing something or you’re crazy, and I’m pretty sure your doctor is missing something. This is one of the main differences between conventional medicine and functional medicine. Through functional medicine, many doctors focus on health care rather than sick care. We’re looking for more subtle deviations from optimal.
Until your liver function is considered abnormal according to the current standard, your liver cells may already be dying. A functional medicine doctor may review your lab tests differently than a conventional doctor. This is primarily because the reference ranges that we’re focusing on aim towards optimal health, not disease. Many conventional doctors evaluate lab tests differently than functional medicine doctors, and then they either follow a “watch-and-wait approach”, or they label you as “not sick” after the most minimal amount of lab tests. As a matter of fact, one patient who visited me had blood sugar levels of 120, where a blood sugar of 126 is already considered type 2 diabetes. And I said, “Did you see your doctor regarding this?” And he said, “Yeah.” I asked him what the doctor said. And he finally said, “Well, he said to wait until I actually had diabetes and then to come back for medication.” And that is the last thing we want to be doing as healthcare professionals.
Reference ranges give us an average number of values which have been recorded among the general population. But let’s not forget, “normal” reference ranges are relative. They change based on age, gender, physical activity, and more. If you were to evaluate an individual’s weight in the United States today, it would be normal to be overweight, as I mentioned, only because 70 percent of people are overweight. And unfortunately, we keep changing our reference ranges based on our sick population. This is not what we should aspire to do as doctors. This is why functional medicine treats the individual, not only the numbers.
Additionally, reference ranges which were once considered normal can also change over time. One instance of how reference ranges change was demonstrated by a known global laboratory company called LabCorp, where they recently changed their reference ranges for male testosterone levels. Previously, LabCorp considered normal testosterone levels for an adult male to be between 348 to 1,197. This value was based on a population of lean adult males. However, in 2017, they lowered normal testosterone levels for an adult male to be between 264 to 916. Moreover, overweight men, excluding obese men, were probably included in the cohort study, ultimately changing reference ranges for male testosterone levels. Research studies have found that excess abdominal fat can cause lower testosterone levels. By changing reference ranges, however, this demonstrates that conventional medicine is considering overweight individuals to be a part of the norm. But this isn’t what we want. We want to strive for overall well-being.
This is why you need to start taking control of your own healthcare. As one in two people have some type of chronic disease, we have to evaluate how we interpret lab tests as well as how “normal” may not necessarily mean health and wellness but simply an average for a growing sick population in the United States.
The primary goal of this series of videos is to encourage you to become the leader of your own well-being by understanding what your lab tests mean, understanding what optimal looks like, and understanding which lab tests are designed to help you achieve overall health and wellness rather than focusing on the disease. I would also like to educate you in order for you to make an informed decision on who you choose to be your doctor, or partner, in your journey to well-being. Now let’s look into the most common medical measurements: your vital signs.
Your vital signs are initially taken by the nurse when you visit the doctor. These vital signs generally include blood pressure, weight, heart rate, temperature, and even oxygen saturation. However, are you aware of what these numbers mean? Has your doctor discussed these numbers with you? Why would they take your vital signs if they’re just going to record them and never discuss them with you? Do the numbers actually demonstrate your health and wellness? If you have high blood pressure or a heart rhythm problem, your healthcare professional is most likely going to tell you, but otherwise, you may not find out what the value of your vital signs is.
Your heart rate is probably one of the most important vital signs taken during a doctor visit. The pulse is a measure of how fast your heart is beating. The human heart beats more than 115,000 times per day. So, if your heart rate is above 100, then we define that as having a high heart rate. But, if you have a heart rate higher than 80, that can increase your risk of developing heart disease. What causes this increase? Although many factors can lead to cardiovascular disease, stress is one of the most common causes because it raises your adrenaline and causes increased heart rate and blood pressure. Drinking too much coffee, stimulating medicines like Adderall, or an overactive thyroid, heart or lung health issue can also increase the risk of heart disease.
The fight-or-flight response, a physiological reaction which becomes activated during times of stress, can also cause an increase in heart rate. When an individual’s heart rate is frequently above 80, it might be time to begin incorporating some stress management techniques into their life, by way of instance, mindfulness meditation and other forms of meditation. Stress is not the only cause of an increased heart rate. Anxiety, magnesium deficiencies, being out of shape and dehydration can also cause an increased heart rate. Ideally, we want to achieve a lower heart rate, optimally under 70.
On the other side of the spectrum, a decreased heart rate below 60 might also demonstrate the presence of thyroid gland dysfunction or low thyroid function. Athletes and distance runners actually have low heart rates because they’re so well-conditioned. Their heart rates can be as low as 50 or even 45. But, if you have a low heart rate and you’re not an athlete or a distance runner, it may be time for you to go talk to your doctor.
While heart rate is one of the most important vital signs taken during a doctor visit, there’s another vital sign which can be just as important, your heart rate variability. This reflects the health of your automatic or autonomic nervous system, which is in charge of controlling all of the unconscious elements of your nervous system, such as digestion and breathing. Heart rate variability has frequently been associated with longevity and even death. The less variable the heart rate is, the higher the mortality rate. Many doctors don’t measure a patient’s heart rate variability, but fortunately, you can manage it yourself. Hot-and-cold therapies, saunas, exercise, yoga and meditation, can all help improve a patient’s heart rate variability.
Now let’s move on to the next most important of the vital signs taken during a doctor visit, blood pressure. If you were to line up all the blood vessels in your body, they would extend approximately 59,000 miles. That’s almost seven times around the earth. These same blood vessels carry over 7,500 liters of blood throughout your entire body on a regular basis. With each heartbeat, blood is pushed against the artery walls, which causes an increase in pressure.
Medical measurements for blood pressure have two numbers. The top number is known as systolic, or the pressure when the heart is contracting, and the bottom number is known as diastolic, or the pressure when the heart is relaxing or at rest. Normal reference ranges for blood pressure continue to change because we keep finding out that the reference ranges we used to think of as normal, which were first 140/90, then 130/80, were still associated with an increased risk of stroke and heart attack. Many doctors today may mention a problem with your blood pressure only if it’s over 130/80.
The reason why blood pressure is so important is because when it’s elevated, it can place additional pressure on the heart and arteries, potentially leading to heart disease, or stroke, heart failure, or even kidney failure. And it’s not only the heart and arteries which are affected by blood pressure: the brain, kidneys and even the eyes can all be tremendously affected, leading to strokes, dementia, kidney failure, and blindness, among other health issues. Maintaining your blood pressure at an optimal level is fundamental towards your overall health and wellness. As a matter of fact, normal blood pressure is currently believed to be under 120/80, however, it may turn out to be even lower.
While high blood pressure is bad, low blood pressure can also be just as bad. A good functional medicine doctor will discuss with you the risks of both high blood pressure and low blood pressure. Blood pressure below 100/60 may cause problems but not necessarily. Blood vessels in the human body function just like pistons in a car. If not enough pressure is built up, it can become really difficult for the blood to flow against gravity. And because the human brain is positioned higher than the heart, we depend on our blood pressure to supply our brain with the necessary amount of oxygen and nutrients required to function accordingly.
If you have low blood pressure, you might experience other symptoms, such as fatigue. Other symptoms associated with low blood pressure include dizziness when standing, weakness and even brain fog. Also, both chronic high blood pressure and chronic low blood pressure may contribute to an increased risk of dementia.
Now we’ve discussed the importance of heart rate and blood pressure. But, how about we discuss another important vital sign: your body temperature? A fever or an elevated body temperature can often be a sign of infection. Temperature can also provide an insight into the function of our metabolism. The lower an individual’s metabolism, the less heat they produce, which may manifest as a slightly lower-than-normal body temperature. The thyroid gland plays a big role in metabolism and regulating your temperature. So, if you frequently feel cold, you might want to discuss ordering the right thyroid panel with your doctor. But, what tests should you ask your doctor to determine this? Don’t worry, we will discuss which thyroid tests you should take in the video on hormones. The optimal body temperature should be approximately 98.6 degrees Fahrenheit. If it’s lower than 97.7 degrees Fahrenheit, however, it may indicate that you have a thyroid problem.
The final medical measurements we’re going to discuss are your height and your weight. Doctors utilize your height and weight to calculate your body mass index, or BMI. At our clinic, by way of instance, we utilize the InBody 770, a body composition and body water analyzer, to help easily determine your body mass index and more. However, body mass index doesn’t always factor in body composition, or the percentage of fat versus muscle in the human body. By way of instance, a pro football player who is 6’6” and 265 pounds has a body mass index of over 30, which puts them in the obese category.
But if you were to take a look at this individual’s body, they would never be categorized as obese. This demonstrates that BMI isn’t an accurate measurement, especially for athletes. Also, a 65-year-old woman may have more fat than muscle in their body while their BMI measurements may appear “optimal”. Instead, many functional medicine doctors use waist-to-hip medical measurements. This is a simple measurement you can do at home to determine body fat distribution, which can also help demonstrate the risk of metabolic dysfunction. Obesity, type 2 diabetes, and heart disease are caused by excess belly fat or fat accumulated around the organs. Excess fat around the midsection can ultimately increase the risk for heart disease and metabolic issues, such as diabetes, dementia, cancer and many other health problems.
But first, let’s discuss how you can calculate your waist-to-hip ratio. To measure your waist, you simply take the measurements of the widest area around your waist, which is generally the biggest part around your belly button. To measure your hip, you then take the measurements of the widest area around your hip, which is generally where your hip bones are on your sides. So, you take these measurements and then you divide the measurements of your waist by the measurements of your hip. And this is the most fundamental number you have to look at.
In men, a waist-to-hip ratio of less than 0.9 is considered optimal. If the ratio is greater than one, meaning that your belly is bigger than your hip, it can put men at higher risk of developing metabolic syndrome, heart disease, diabetes, stroke, cancer, and dementia. In women, a waist-to-hip ratio of less than 0.8 is considered optimal. If the ratio is greater than 0.85, it can put women at higher risk of developing metabolic syndrome as well as the other health issues mentioned above.
Medical measurements, including heart rate, temperature, respiration rate, and blood pressure, are several vital signs which help indicate doctors the state of a patient’s fundamental body functions. Reference ranges today are utilized to determine “normal” health and wellness spectrums, however, research studies have demonstrated that these reference ranges may actually not be optimal spectrums. Understanding the most basic medical measurements, or vital signs, is important towards a patient’s well-being, as it can help people recognize whether they are feeling healthy or sick, regardless of the standards.
And those were your vital signs, your most basic medical measurements. These numbers are very essential as they are fundamental towards your overall health and wellness. Understanding how your body functions as a whole is important to optimize your well-being. Therefore, next time you visit your doctor, ask about your vital signs and discuss these reference ranges with them. I truly believe that a combination of your own research and having a good relationship with a qualified healthcare professional can lead you on the right path to overall health and wellness.
Finding a doctor that will work with you is essential towards achieving the results you deserve. If your doctor is not willing to have a conversation with you about your well-being or the lab tests that are needed to track your results, then you might want to consider finding another doctor.
If you learned about the simplest medical measurements then you will definitely enjoy the next video, where we will discuss the blood tests utilized to determine nutritional deficiencies. Over 90 percent of individuals in the United States are deficient in nutrients at the RDA level. That’s the minimum amount necessary to prevent diseases caused by nutritional deficiencies, such as scurvy and rickets.
We’re going to discuss how a doctor who specializes in functional medicine evaluates results and what other tests your doctor might be unaware of that can tell us a lot about your nutritional status. Thanks again for joining me so far and I’ll see you later. The scope of our information is limited to chiropractic and spinal health issues as well as functional medicine topics and discussions. To further discuss the subject matter, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900 .
Curated by Dr. Alex Jimenez
Back pain is one of the most prevalent causes of disability and missed days at work worldwide. Back pain attributes to the second most common reason for doctor office visits, outnumbered only by upper-respiratory infections. Approximately 80 percent of the population will experience back pain at least once throughout their life. The spine is a complex structure made up of bones, joints, ligaments, and muscles, among other soft tissues. Injuries and/or aggravated conditions, such as herniated discs, can eventually lead to symptoms of back pain. Sports injuries or automobile accident injuries are often the most frequent cause of back pain, however, sometimes the simplest of movements can have painful results. Fortunately, alternative treatment options, such as chiropractic care, can help ease back pain through the use of spinal adjustments and manual manipulations, ultimately improving pain relief.
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The information herein on "Functional Medicine Part 2: Vital Signs" is not intended to replace a one-on-one relationship with a qualified health care professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional.
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Our information scope is limited to Chiropractic, musculoskeletal, physical medicines, wellness, contributing etiological viscerosomatic disturbances within clinical presentations, associated somatovisceral reflex clinical dynamics, subluxation complexes, sensitive health issues, and/or functional medicine articles, topics, and discussions.
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Dr. Alex Jimenez DC, MSACP, RN*, CCST, IFMCP*, CIFM*, ATN*
email: coach@elpasofunctionalmedicine.com
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Dr. Alex Jimenez DC, MSACP, RN* CIFM*, IFMCP*, ATN*, CCST
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