top of page

Your Bloodwork is Normal but is it Optimal?

After I developed alopecia universalis, quite suddenly, 8 years ago, I was extremely confused. I had always considered myself in good health, and my yearly physicals always showed bloodwork in normal ranges. Over the subsequent years I asked my doctor to run countless blood tests, always searching for clues. Almost everything came back "normal", and so there was nothing that could be done.

In 2021, I started working with a practitioner who looked at labs differently. She was not looking for normal, she was looking for optimal. Normal ranges are based on the general population, while optimal ranges are based on the healthy population. I was surprised and delighted when, after she received my labs, she found lots of "healing opportunities". I have since become a certified Integrative Healing Practitioner, and I've learned how to read my own labs. I've also read the labs now of dozens of other people, and I can say with confidence that a full blood panel with the right tests can be a treasure trove of healing opportunities.

As an example, here is my thyroid panel from last February. I'd always thought my thyroid was perfectly normal, but when compared to optimal ranges, it's sluggish.

After adding basic nutrients including a multi mineral containing iodine, along with some tyrosine, I was able to improve my thyroid function. Here are my labs from October. Still not perfect but going in the right direction:

Similarly, I was able to improve my vitamin D, vitamin B12 and ferritin. Have you ever had high iron but low ferritin? It indicates a problem converting iron into the storage form, and can be frustrating. This can be due to a lack of cofactors, such as minerals and vitamin C, but can also be due to methylation problems, which was definitely a big issue for me. These are my labs from February 2021. By October 2022, my ferritin was up to 90, and iron was in the normal range.

I also take a very close look at the Complete Blood Count, because there is a lot of great information to be gleaned here. I have high MCV, which means my red blood cells are large and there aren't a lot of them, which can result in reduced oxygen flow around the body. This can contribute to fatigue and cold hands and feet. I've been sleeping with socks on year round, despite living in North Carolina, for the last 8 years, and I suspect this has something to do with my cold feet. High MCV is caused by low B12, folate, or iron. And since I know methylation is an issue for me, I have suspected B12 or folate (both important in methylation) to be low.

One of the most important markers on the blood panel is serum homocysteine. Homocysteine is an amino acid that forms an important part of the methylation cycle, which is a very important detoxification pathway. If homocysteine is high, it means it is not being recycled into methionine. This can be caused by several different genetic mutations, but the most common one is MTHFR C677t. This gene is integral to the movement of homocysteine through methylation. A homozygous mutation on this gene can cause a reduction in the enzyme function of 70%, so when this or other mutations important to methylation are present, and homocysteine is high, it is important to support the reduced function with the active form of B12 (methylcobalamin) and folate (methylfolate). High homocysteine, if left high for years, can lead to atherosclerosis and heart disease, and cause other health problems due to impaired methylation.

When homocysteine is low, it is also not great, as it means there is an active mutation on the CBS gene, which will also cause homocysteine to not be recycled back into methionine. Instead, homocysteine barely makes it into the methylation cycle before it is shunted down a different pathway called Transulfuration. The body may turn this gene on when it needs glutathione due to a high toxic burden, as this is the pathway that produces glutathione. But it comes at the expense of a functioning methylation pathway. It also produces ammonia when it is shunted down this pathway, which is a neurotoxin, and taurine.

Knowing whether or not CBS is active is important, because if it is, it needs to turn off before methylation can function properly. And to get it to turn off requires work. When I had homocysteine measured in February of 2021, it was 7.2, which is considered optimal. However, I had genetic mutations that made it possible that CBS could be on, so I had to "test it" to find out. And the way to test CBS is by adding methyls and measuring homocysteine again. If it dips below 6.0, it's active, and methyls need to be stopped until CBS turns off. Sure enough, the next time I tested, my homocysteine was 5.9, so my CBS was active.

So now I knew that, even though lots of other issues I had required methyls, I couldn't add methyls because I would be further impairing methylation, and creating more ammonia, by doing so. I had to find out what was causing my active gene and hopefully fix it so that I could safely add the methyl groups that I really need to heal. In the next post, I'll explain how I did that.

Addressing deficiencies and issues found through bloodwork has been a huge part of my healing journey. I still have alopecia, but my other big issue, fatigue, is 95% improved. My mood is great. My skin looks better. My hair is getting better. I'm moving in the right direction.

Have you ever been told your bloodwork was all normal and there was nothing to be done about your symptoms?

Recent Posts

See All


  • Facebook
bottom of page