Medical Testing

Bubble?

Over-Reliance on Lab Tests Has Worsened Medical Practice Pam Popper, President Wellness Forum Health According to an article published in 2024, overuse of lab tests in hospital settings contributes to both the high cost of healthcare, and the mistreatment of patients. Consequences include hospital-induced anemia and other poor outcomes.[1] We’ve been telling our members for almost three decades now that this is the case and that the issue is not limited to hospital settings. There are several reasons for this, which include but are not limited to the expansion of testing – more and more measurement of more biomarkers; and also reference ranges which have become increasingly unreliable for many reasons.  In fact, according to an article posted on Medscape, "A truly exact range for laboratory values exists only theoretically."  This article also states that lab results are not just numbers to memorize, and that correct interpretation requires context, knowledge and clinical judgment.[2] In a perfect world, each lab is supposed to establish reference ranges for all biomarkers measured. This process involves testing at least 120 healthy people in each demographic group and using the middle 95%. The top and bottom 2.5% are excluded. But the world is not perfect, and many labs do not follow this process. Instead, they rely on reference ranges reported in medical journals and often adjust for differences, which can include differing analytical systems, methods, environmental factors (like lab water quality) and reagents. These differences can be quite significant, and attempts to harmonize have not worked with the exception of markers like cholesterol and hemoglobin A1c.[3] Additionally, so-called "expert panels" influence reference ranges too. In some cases, this makes sense. For example, in the U.S. the average BMI is 30. Applying the "central 95% standard" to this metric would mean that obesity would be considered "normal." An adjustment is clearly needed in this case. On the other hand expert panels, many of which are made up of highly conflicted professionals sponsored by Big Pharma, have changed reference ranges for biomarkers like blood pressure, cholesterol, and thyroid-stimulating hormone (TSH) so much that almost everyone can be diagnosed with something.  This is a process we call "disease mongering" and it benefits drug companies but almost never benefits patients.  Yet another issue is that lab results almost never consider age or sex. For example, prostate specific antigen increases with age, and increasing PSA levels may not signify cancer. And normal iron levels for women indicate anemia for men. Lab results are particularly irrelevant when measuring nutrient levels. In addition to the uncertainty of which of the thousands of nutrients you should be tested for, testing is not a very precise science. One of the reasons is that human biochemistry is complex, and values can vary from minute to minute. This means that a test performed at 10:00AM might yield different results than a test performed at 9:45AM. Fortunately the body is able to respond to this variability by practicing "selective absorption,"[4] extracting and absorbing exactly the nutrients needed from the foods consumed at any time. Once in the body, there’s even more variation as nutrients follow different pathways depending on the body’s needs at a particular time - energy vs cellular repair, for example. Sometimes lab values are just made up.  Perhaps the most egregious example of this is the billion-dollar industry that has developed around vitamin D status.  It’s not a vitamin, it’s a hormone.  There are no reliable testing methods.  There is no consensus as to what optimal plasma levels of vitamin D should be.  No one knows how much vitamin D a person needs to take to increase plasma levels. There is no proven connection between higher plasma vitamin D levels and better health outcomes.  Supplementation benefits very few people, and there are known harms that can result from taking vitamin D supplements. (see several referenced articles on this topic in the Health Briefs Library)  None of this seems to matter – those who have carved out their piece of this billion-dollar fraud are not about to give it up.    These points are not an argument for ignoring lab tests. They are necessary in many cases.  But it is an argument for clinical judgment instead of blind adherence to so-called "normal values" or fixed reference ranges that have changed in many cases due to industry influence.  It’s time to do less testing and more relationship building between health professionals and their patients. Humans are not machines and their bodies cannot be maintained and/or repaired based on universal norms and standards. [1] Shaik T, Mahmood R, Kanagala SG et al. "Lab testing overload: a comprehensive analysis of overutilization in hospital-based settings." Proc (Bayl Univ Med Cent) 2024 Feb;37(2):312-316 [2] Wolfgang Paik. When Leb Reference Values May Mislead Clinicians. Medscape March 10 2026 [3] Ceriotti F. "Harmonization Initiatives in Europe." EJIFCC 2016 Feb;27(1):23-29 [4] Cheraskin E, Ringsdorf WM. New Hope for Incurable Diseases  Exposition Press New York 1971 pp 24, 25, 4