{"id":8095,"date":"2025-06-03T12:57:31","date_gmt":"2025-06-03T16:57:31","guid":{"rendered":"https:\/\/www.silvercentury.org\/?p=8095"},"modified":"2025-06-03T12:57:31","modified_gmt":"2025-06-03T16:57:31","slug":"know-your-numbers","status":"publish","type":"post","link":"http:\/\/78.142.243.82\/~silvercentury\/2025\/06\/know-your-numbers\/","title":{"rendered":"Know Your Numbers"},"content":{"rendered":"

Every year, millions of older adults roll up their sleeves for an annual physical. Blood is drawn, a cuff tightens around the arm, and a stethoscope taps against the chest. A few days later, a patient portal pings with test results, unleashing a barrage of numbers: cholesterol levels, blood pressure readings, blood glucose, creatinine and more. <\/span><\/p>\n

It’s like receiving a report card in a language you don\u2019t speak.<\/span><\/p>\n

What do all these numbers mean? Is it important for patients to understand and track them from one year to the next? And if a lab test produces an abnormal result, should you worry, wait or push your physician for action? <\/span><\/p>\n

\u201cThere are so many tests out there that it’s very confusing for patients,\u201d acknowledged Darshan Kapadia, MD, senior internist at Texas Health Plano in Plano, TX. <\/span><\/p>\n

Understanding your numbers can help you ask informed questions, advocate for your own health care and partner more effectively with your health care provider. At the same time, health care professionals caution, it\u2019s important to put numbers in context. No single lab result tells the whole story. And determining what\u2019s normal for each patient\u2019s personal health situation is more complicated than it looks. Numbers alone don\u2019t determine diagnoses; they\u2019re data points that must be weighed along with a patient\u2019s health history and physical exam.<\/span><\/p>\n

\u201cThere\u2019s more to the story than just those numbers on the lab sheet,\u201d said Rebekah Mulligan, MD, an internal and geriatric medicine physician at Texas Health Harris Methodist Hospital in Southlake, TX. <\/span><\/p>\n

More Isn\u2019t Always Better<\/b><\/p>\n

Understanding your personal numbers is more important than ever, now that many patients have direct access to test results. The growth in health information technology, especially patient portals, means more and more data is relayed straight to patients, sometimes in bewildering detail, often without medical guidance. <\/span><\/p>\n

But more information isn\u2019t always a good thing. This windfall of data to patients comes at a time when primary care physicians are increasingly in short supply and pressed for time to explain those results.<\/span><\/p>\n

\u201cClinicians have expressed concern that patients often experience great difficulty in comprehending, interpreting, and correctly responding to personalized health information,\u201d according to a 2020 study published in the <\/span>Israel Journal of Health Policy Research<\/span><\/i>. \u201cIn particular, misunderstanding test results leads to confusion, frustration, and disruptions in healthcare processes, including delays in seeking care, overutilization of services, medication errors, and inappropriate healthcare decision-making.\u201d <\/span><\/p>\n

At the same time, in most states, patients can now take advantage of \u201cDIY diagnostics\u201d by ordering their own blood tests at medical labs, without guidance or orders from medical professionals. At-home medical and wellness testing is exploding; it\u2019s now a $5 billion market in the United States. <\/span><\/p>\n

Advocates say this expanded pool of available information gives patients more options when they\u2019re looking for answers to hard-to-diagnose health issues or waiting for months for medical appointments. But medical professionals argue that it can be risky for patients to interpret their own results. Some may panic over an out-of-normal-range result that isn\u2019t necessarily concerning\u2014or assume that a blood workup with only normal results means they\u2019re healthy. <\/span><\/p>\n

Normal vs. Abnormal<\/b><\/p>\n

In reviewing their lab results, one common assumption many patients make is viewing the numbers as either \u201cnormal\u201d or \u201cabnormal.\u201d But physicians take a more nuanced view. Even the term \u201cnormal\u201d can be misleading. <\/span><\/p>\n

\u201cIt\u2019s important for patients to understand how the medical profession comes up with what is considered the normal range,\u201d said Diana Cardona, MD, professor and chair of the department of pathology at Wake Forest University School of Medicine. For example, a white blood count (WBC) of 4,500\u201411,000 cells\/mcL is considered within normal range. Researchers developed that range by looking at data from large groups of healthy individuals. The range of numbers where 95 percent of those patients landed is designated as normal. <\/span><\/p>\n

\u201cBut that\u2019s really just a statistical number,\u201d Cardona said. \u201cThere\u2019s the 5 percent on either end of the range who are still healthy people, but now we\u2019ve called them abnormal.\u201d <\/span><\/p>\n

Cardona prefers the term \u201creference range\u201d rather than \u201cnormal range\u201d for that 95 percent. <\/span><\/p>\n

Context is important too. Two patients with the same borderline cholesterol numbers, for example, might need totally different treatment approaches.  <\/span><\/p>\n

\u201cIf a patient has diabetes and high blood pressure, I need them at a much lower cholesterol level to control their risk, compared to a patient without diabetes or high blood pressure,\u201d said Donald Lloyd-Jones, MD, director of the Framingham (MA) Center for Population and Prevention Science and <\/span>chief of preventive medicine at the Chobanian & Avedisian School of Medicine and Boston Medical Center<\/span>.  <\/span><\/p>\n

Doctors take into account how much a number on a test changes from year to year and how quickly.<\/b><\/p><\/blockquote>\n

Almost every number comes with asterisks\u2014exceptions to the rule when it comes to interpretation. Body mass index (BMI) seems like a straightforward way to determine whether a patient is at a healthy weight: a BMI of 19-24 is considered healthy; 25 or higher is overweight; over 30 is obese. <\/span><\/p>\n

But according to the American Heart Association, a BMI number should be \u201cinterpreted with caution\u201d among persons of Asian ancestry, older adults and muscular individuals. For adults 65 and older, recent studies link somewhat higher BMI numbers to better health and higher chances of survival. Similarly, a weight lifter with very little body fat could have a higher body weight that yields a BMI that labels them \u201cobese.\u201d The Heart Association also recommends factoring in waist circumference, which helps determine how much body fat has accumulated around the middle section, which is associated with higher cardiovascular risk. <\/span><\/p>\n

Doctors also look at individual trends\u2014how much a number changes, and how quickly, from one year to the next. That can be especially important for lab tests like the prostate specific antigen (PSA), which helps detect prostate cancer in men. <\/span><\/p>\n

\u201cIt\u2019s really important to keep an eye on the rate of change,\u201d Mulligan said. \u201cSay you go to a new doctor, and you have some abnormal numbers. The doctor will want to know, \u2018Is this where you\u2019ve always been, or is this a new thing?\u2019 Because if it\u2019s a new thing, it\u2019s a bigger deal in some instances.\u201d  <\/span><\/p>\n

Tracking Your Numbers<\/b><\/p>\n

Any time new test results come in, Kapadia goes over the written report and encourages the patient to scan or photograph the report for their own records. Keeping track of your numbers can prove useful in a medical emergency or if you change providers.<\/span><\/p>\n

\u201cHave a folder somewhere in your cell phone titled, \u2018My health record\u2019 and keep your reports in there,\u201d he advised. \u201cThen make sure you can find it in your phone\u2014not in the cloud\u2014so that you don\u2019t need the internet to retrieve the information. So, if you’re traveling, and, say, you’re on a safari in Africa and something happens, you’ve got the data to look at right there. You don\u2019t have to remember it or understand it, because the physician on duty can review it from your phone.\u201d <\/span><\/p>\n

Patients can also take advantage of a growing body of tools designed to help patients interpret their own key medical metrics in context. Lloyd-Jones and the American Heart Association created <\/span>Life\u2019s Essential 8<\/a>,<\/span> a checklist to help patients understand key numbers (cholesterol, blood pressure, blood sugar and body weight) in combination with lifestyle factors (exercise, sleep, diet and nicotine exposure) to assess and manage their cardiovascular health. The American Heart Association also offers \u201cKnow Your Numbers\u201d<\/a> fact sheets for <\/span>patients with diabetes <\/span>and for <\/span>women concerned about their heart health<\/a>.<\/span> <\/span><\/p>\n

Researchers are also working on making the lab results and other reports easier for patients to understand. Cardona is part of a College of American Pathologists research project exploring ways to make pathology reports more patient-friendly. In focus groups with cancer patients, she was surprised to learn that they didn\u2019t want the information summarized in plain language. Learning the medical terminology helped them speak more easily with their care team. But they did want more explanation, such as a glossary of terms. <\/span><\/p>\n

Handling Abnormal Results<\/b><\/p>\n

If a number is somewhat out of normal range, and your physician says, \u201cDon\u2019t worry” or “Let’s wait and see,” should you question that?   <\/span><\/p>\n

\u201cThat\u2019s the art of medicine\u2014understanding when those red flags are a big deal and when they\u2019re not,\u201d said Mulligan. \u201cSometimes patients can get hung up on an [out-of-range result] and ask for more intense testing that\u2019s not clinically applicable. I try to explain why that number is OK in this situation.\u201d <\/span><\/p>\n

But tell your doctor if a test result worries you, Mulligan added. <\/span><\/p>\n

\u201cKeep asking questions,\u201d she said. \u201cYou can say, \u2018I hear what you\u2019re saying, and I\u2019m not trying to second-guess you, but can you show me what it says in the literature so that I can educate myself?\u2019 I would much rather have a patient do that than worry for the next 12 months.\u201d <\/span><\/p>\n

Remember that any lab result is a snapshot of a particular day and time. Many factors can skew the results of a test on a particular day. An abnormal kidney function number might indicate the patient has kidney disease\u2014or is mildly dehydrated, which is common in hot weather. Certain medications or supplements may affect the results of kidney or liver function tests. Mulligan often sees that in patients who take biotin or hair-growth supplements like Nutrafol. <\/span><\/p>\n

When is blood pressure too low? There\u2019s no accepted number. Low blood pressure is diagnosed by symptoms instead. <\/b><\/p><\/blockquote>\n

\u201cThat\u2019s why it\u2019s so important to tell your physician if you\u2019re taking anything\u2014including supplements or over-the-counter medications\u2014that may not be on your medications list,\u201d Mulligan said. \u201cAnd don\u2019t assume the information in the [medical practice\u2019s] computer is up to date. Always bring a written list to your appointment.\u201d <\/span><\/p>\n

Conversely, understand that even a complete battery of tests with entirely normal results doesn\u2019t guarantee that a patient is healthy. Kapadia recently diagnosed a patient with lymphoma; that patient\u2019s blood work was 100 percent normal. An imaging test revealed the presence of cancer. <\/span><\/p>\n

Also, know that some numbers have clear cut-off levels; others do not. <\/span><\/p>\n

\u201cOptimal blood pressure is defined as less than 120 on the top number and less than 80 on the bottom number,\u201d said Lloyd-Jones. \u201cBut there\u2019s no hard-and-fast number for blood pressure that\u2019s too low. For many patients, a top number in the 90s may be normal and healthy and certainly means they\u2019re at lower risk for strokes or heart failure. But if the patient gets light-headed when they stand up, that\u2019s too low for them. The lower limit on blood pressure is defined by symptoms rather than a specific number.\u201d <\/span><\/p>\n

Changing Interpretations<\/b><\/p>\n

Another caveat: as new research emerges, medicine changes. For example, the numbers you\u2019ve heard for years for healthy cholesterol levels may no longer apply. <\/span><\/p>\n

Until recently, physicians typically assessed cardiovascular health with a lipid panel that calculated total cholesterol as a combination of \u201cgood\u201d (HDL) and \u201cbad\u201d (LDL) cholesterol along with triglycerides. Today, those numbers are still considered, but as part of more-complex algorithms that also factor in other metrics (such as blood sugar and blood pressure) as well as gender, age, smoking status and family history in determining whether to prescribe medications for high cholesterol or high blood pressure. <\/span><\/p>\n

\u201cWe want the LDL to be as low as possible, but we\u2019ve de-emphasized HDL as a target of therapy, because medications don\u2019t really help move that number,\u201d Lloyd-Jones said. \u201cAnd there\u2019s more focus on triglycerides, which are more sensitive to diet and exercise and a better indicator of current metabolic health.\u201d <\/span><\/p>\n

That complexity makes it even more important for patients to ask questions and engage in back-and-forth as needed with their primary care physicians. <\/span><\/p>\n

\u201cA good relationship with your physician is worth its weight in gold,\u201d said Kapadia. \u201cThat\u2019s why it\u2019s so important to find someone you like and trust and to start developing that relationship with them. So you can work together to understand and personalize those numbers for your own situation.\u201d<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

Every year, millions of older adults roll up their sleeves for an annual physical. Blood is drawn, a cuff tightens around the arm, and a stethoscope taps against the chest. A few days later, a patient portal pings with test…<\/span><\/p>\n

Read more Know Your Numbers<\/span> ›<\/span><\/a><\/div>\n

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