As one of my teachers used to say "The body signs will never lie. People may lie, but you must trust in the tongue and pulse." The longer I am in practice, the more I realize the truth behind that statement. For example, I often have patients who come in complaining of all the signs and symptoms of anemia, or what we like to call in Chinese Medicine, Blood Deficiency. The patient may have fatigue, sensation of cold, hair loss, insomnia, and dizziness when standing up too quickly. Moreover, upon examination their tongue color would be pale, their pulse very thin, which are all defining characteristics of Blood Deficiency. But because their doctor has told them that their blood levels are within the clinical range of "normal," these patients have a hard time believing they are still blood deficient. 

Or on the other end of the spectrum, some patients keep going back to their doctors time and again because they feel indisputable symptoms. But the blood tests keep coming back negative for any anomalies, so their doctors dismiss the patient's concerns, leading many of these patients to seek alternative treatments. Case in point, a patient came to me because she was having uncontrollable weight gain (over 20 lb within 3-4 months). At the doctor's advice, she had tried dieting, exercising, taking supplements, and after months of severe 1200 calorie, no carb, very low-fat dieting, and months of exercising regularly, she was still only able to maintain but not lose the weight she had gained. Since blood tests for her thyroid levels showed normal, doctors passed it off as a side effect of being in peri-menopause. After examining this patient, I found her to have a very sluggish, low-energy pulse, a purple colored tongue with teethmarked edges, and along with reported symptoms of constipation, brain fog, poor memory, fatigue, and dryness of the skin and hair, she clearly had issues with insufficient thyroid function, no matter what the blood test said. 

Sometimes blood tests can be unspecific. For instance, a popular test for the autoimmune disease Lupus is the ANA blood test. But just because the ANA is positive is not proof positive of Lupus. It could indicate a number of other autoimmune diseases, or it could indicate nothing at all. Blood tests are also not always accurate. For example, many studies have shown that for women, taking the blood before versus during their menstrual cycles can result in large fluctuations in iron-status measures. A blood test can really only look at a brief window in time. Whereas persistent symptoms may point to some underlying cause that may belie the common blood report.

In the case of the blood deficient patient, it could be a simple matter of the doctor not ordering the right test. It is entirely possible to be iron deficient without being clinically anemic, and a simple CBC panel, where the total number of red blood cells is measured, cannot detect subclinical iron deficiency. But even with supplementation, sometimes it is not enough. There is a saying in Chinese medicine -- "too deficient to receive tonification" -- where because of a chronic deficiency, the body may not be absorbing supplements or tonics, even when you are taking them in great quantities. In the case of the thyroid patient, even if her body is producing adequate quantities of thyroid hormones, it is possible that her cells are not responding to the hormones. 

If you are ever in doubt about your blood test results, never be afraid to ask. If you feel that your body is telling you something isn't right, or not congruent with what your doctor has diagnosed, you should try to find out the reason behind it. Chinese medicine can be a great resource because we look at the body as a whole, and can often point out a common root cause, even with many different symptom presentations. But whether it's Chinese medicine or conventional medicine, the most important fact to remember is that in the end, you probably know your own body the best, and you should trust your instincts, and be your own health advocate!