Page 2 - Autoimmune Diseases Blood Testing

results are not in that range, then we wonder if we can help a patient get into that range, will they
feel like a healthy person? Like an astronaut, for example.”

There is a difference between the statistical range that is used to determine the
“reference/normal” range and the physiologic range—where human beings are optimally
functioning. The statistical range is simply based on statistics and who has been tested.

“When labs test people, they test a lot of people, and they get a lot of results,” explains Dr.
Bilstrom. “Some results are on the lower end of the range and some results are on the upper end.
If I, for example, decide to test the height of 100 people, I will find that some people are short,
some people are tall, but most people fall in the middle.”

When a lot of testing is done, there tends to be a distribution of results that looks like a bell-
shaped curve with the mean (average results) right down the middle. Like a grading curve in
school. Some results are on the lower end and some results are on the upper end, with the
majority in the middle. When labs see this distribution, they say “how can we come up with
some kind of range to put on this result sheet.”

In statistics, 95 percent of all results fall within two standard deviations of the mean, which is
two portions towards the higher numbers and two portions towards the lowers numbers from the
mean, or the average of the results in the middle. When someone is within the range, it doesn’t
mean you’re fine, you’re healthy, or you’re great. What it really means is you’re not one of the
five worse out of 100.

“It’s like taking a test in school,” explains Dr. Bilstrom. “If you’re within the range, you’re not
an ‘F.’ But that leaves you somewhere between a ‘D-minus’ and an ‘A-plus.’ It’s nice not to be
an ‘F,’ but you also don’t really want to be average at a ‘C, D, or D-minus’ either. Where you
really want to be is an ‘A to B-plus,’ because that’s where the healthy people are.”

If anything ever falls out of the reference range on a blood lab test, whether it’s on the high or
low end, then automatically that person is considered one of the five worst. If someone’s results
falls within the range, we know they’re not an ‘F’ but more information will be needed—to
understand their true ranking.

Knowing that statistics determine the reference range, that’s one reason why different labs have
different reference ranges. No matter what sample group they start with, only five out of 100 can
fall out of the range. It can be 100 sick people—only five fall out—or 100 healthy people—only
five fall out. And usually the people that have tests run aren’t feeling so good. You’re being
compared to people who are already sick.

“If we wait to treat someone when they are actually the five worst out of 100, you’re basically
waiting until someone is almost dead before they are treated,” explains Dr. Bilstrom. “This is as
opposed to treating someone when they are starting to have issues and trying to get them to the
same place our astronauts are at because those are some of the healthiest people.”