The Medicalization of Normal Lab Variations: When ‘Abnormal’ Isn’t Disease.

As professional healthcare providers I can only imagine how many times our patients quoted information from "Google" or another website and attempted to self-diagnose their symptoms and lab values.

Most of us have done it: we get a lab result, Google it, and suddenly we’re convinced something is seriously wrong. With so much health information online, it’s easy to panic — and even easier to misunderstand what a single number really means. The stories below show how “too much information” without context can create fear instead of clarity. The case study below perfectly describes how too much information can be harmful to our patients.

Prediabetes and the Expanding Disease Boundary

A patient came to clinic distressed after a routine health screening showed an A1c of 5.8%. He had been told he had prediabetes. He assumed diabetes was inevitable. The American Diabetes Association emphasizes that prediabetes is not a disease in itself, but rather a risk factor for developing type 2 diabetes.

In his case, no medication was started. We focused on lifestyle measures — modest weight control, diet, and regular activity — and monitored his A1c. On follow-up about a year later, his levels had returned to the normal range, and he did not progress to type 2 diabetes.

In reality, progression from prediabetes to diabetes is far from certain. Depending on definitions and populations, 30%-60% of individuals with prediabetes revert to normal glucose regulation within 1-5 years, and pooled data from prospective cohorts suggest that reversion to normoglycemia can be more common than progression to overt diabetes.

Another case in point follows: Testosterone varies widely depending on time of day, illness, sleep, and laboratory variability. It also declines gradually with age.

The testosterone measurement guidelines emphasize that a diagnosis of male hypogonadism should not be made on a single laboratory value. Morning testosterone should be confirmed on repeat testing and correlated with clinical symptoms before treatment is initiated.

Nevertheless, direct-to-consumer advertising and routine testing have contributed to an increase in testosterone prescriptions — sometimes for men whose levels fall within normal age-related variation.

Why This Happens: The “Gray Zone” of Medicine

Lab results are helpful, but they’re not absolute truths. They’re more like weather forecasts — useful, but not perfect.

A few key points:

• A single abnormal number doesn’t always mean disease.

• Borderline results should be repeated before making a diagnosis.

• Your symptoms and overall health matter more than one lab value.

• Reference ranges are statistical averages, not strict rules.

Modern medicine gives us powerful tools, but if we treat every tiny variation as a problem, we risk labeling normal human changes as illness.

Sometimes the best response to an abnormal lab isn’t a new medication or a specialist visit.

Sometimes the best response is perspective.

As a very wise nursing instructor told me one day when I was bedside evaluating a patient: "Treat the patient, not the number"

REFERENCES: The Medicalization of Normal Lab Variations: When ‘Abnormal’ Isn’t Disease - Medscape - April 28, 2026.

WRITTEN by Cynthia M. Obermaier, RN, BSN.

Assessed and Endorsed by the MedReport Medical Review Board