Asthma and Allergies

This is a repost from the Millar Chiropractic Clinic website.

Asthma and Allergies

Addressing the Cause

One of the most important things you can do if you suffer from asthma and allergies, is to avoid common allergy triggers such as dairy products, corn, soy, peanuts, shellfish, eggs, sugar and gluten. People can be allergic to most any food, and it is often foods that they eat most often and crave that are the culprits.  Some people benefit from following an elimination diet which eliminates all the common allergens (and suspected allergens) from the diet for a specific amount of time.  Usually after a short "detox" period during which time symptoms worsen temporarily, the person begins to feel better than they have in a very long time, or perhaps ever. Then they slowly begin adding back one suspected allergen at a time (usually beginning with foods that are least suspected of being the problem to the most) noting any increase of symptoms.  This allows the person to determine which foods cause or contribute to their allergies. Because gluten sensitivity is so prevalent today, many people simply eliminate gluten in all its forms, and find that is sufficient to alleviate their symptoms.  Eating gluten free is easier than ever with many gluten-free products being carried in most grocery stores, and an internet filled with recipes and advice. It is also important to make sure that you're drinking enough water each day - preferably about eight cups over the course of the day. And no, coffee, tea, juice, and soda don't count. If you're not used to drinking water, start with four cups per day, get used to doing that, and work your way up to eight cups per day. To put it simply, if you're not drinking enough water, your internal metabolic environment is toxic. For those with allergies and other sensitivities, failing to drink enough water can exacerbate the problem. Another very important factor in lowering your toxic load and reducing hypersensitivities is to avoid all fragrances (including those in personal care products like shampoo and conditioner,) laundry detergents, dryer sheets, and toxic cleaning chemicals.  Opt for fragrance free products, and clean with baking soda and vinegar instead.

Asthma and allergies are big business.  Approximately 20 million Americans suffer from asthma, and approximately 50 million suffer from allergies. Taking into consideration the overlap between these two conditions, more than 60 million Americans suffer from either asthma, allergies, or both.

In total, the costs for medications, emergency room visits, hospital admissions, and the loss of business productivity are huge - reaching upwards of $18 billion annually.¹ Additionally, the negative impact on children is ongoing and significant, resulting in 14 million school days that are missed annually due to asthma and allergies. These two disorders are the number one reason for school absenteeism.²

Conventional treatment of allergies and asthma relies upon a variety of medications, and if you suffer from one of these disorders, you know all about the meds. The medications typically used to treat allergies include corticosteroid nasal sprays, and antihistamines. Allergy patients may also undergo immunotherapy, receiving a course of desensitization injections that are given regularly over a number of years.

For asthma, the gold standard of medication is inhaled corticosteroids. Asthma inhalers have become so commonplace that they even appear regularly as props in films and television series. It is not unusual to see a character on screen pull out an inhaler and take a quick dose during "challenging" moments and stressful situations.

One of the frustrations with asthma and allergy medication is that there is no end-point. As of now, there is really no cure, although some lucky people do seem to "grow out of it", and there have been some promising results from specialized breathing exercises in cases of mild asthma.  Most of the time however, allergies and asthma continue to be an ongoing challenge that requires continuing medication. Is it possible that there could be an alternative solution?

"Alternative" is the key word. Conventional medical treatment typically focuses on addressing a patient's symptoms rather than the underlying cause.  With allergies and asthma it's successful to some extent, though the downside is that these symptoms continue year after year, often worsening over time. Is there anything else that could be done?

Consider chiropractic care. The chiropractic health care approach is unique and comprehensive, offering positive benefits to a variety of ailments and conditions. In the case of "hypersensitivity conditions" such as asthma and allergies, chiropractic care can help to normalize the body's flow of nerve signals, thereby reducing symptoms. Chiropractic treatment can also help remove the blockages to the body's innate healing abilities. By correcting these imbalances, chiropractic treatment may help reduce hypersensitivity reactions.

Chiropractic care often includes nutritional counseling, which can be a critical component for people with asthma and allergies. Such individuals need to optimize their physical health as much as possible, and nutritional awareness can play an important role. A balanced diet can help support all metabolic systems, reduce chronic inflammation and irritation, and provide the energy necessary to participate in regular exercise.

The benefits of chiropractic care are wide-ranging, and may be very useful in cases of hypersensitivity disorders such as asthma and allergies.



¹Weiss K: The costs of asthma. Asthma and Allergy Foundation, 1998 [updated 2001].
²The Condition of Education, National Center for Education Statistics, 2001.

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The Skyrocketing Cost of Health Care

This is a repost from the Millar Chiropractic Clinic website.

The Skyrocketing Cost of Health Care

How to Get Started Exercising

In some ways, it doesn't matter what kind of exercise you're doing, as long as you're participating in some kind of regular physical activity. The most important thing is to be physically active in some way, every day or at least almost every day. Exercise is relative. If you're 20 years old, walking a few blocks isn't going to do much for you. But if you're 80 years old, walking three or four blocks might be great exercise. The important thing is to start being active, and make it a regular part of your life. For most of us, the biggest hurdle is just getting started. To exercise or not is a choice, and it's a choice we make each day. Do I choose to spend some time taking care of myself, or do I choose to put it off for another day and instead spend today feeling badly because I didn't do what I'd promised myself I'd do?  The bottom line is that it's actually much easier on oneself to choose the path of positive action. The bonus is that exercise makes you feel good mentally and emotionally because your brain produces endorphins in response to physical activity, so you get an extra bonus of good feelings! Begin slowly, especially if you haven't exercised in a few months or a few years. The goal is not to look like a supermodel or world-class athlete. The purpose is to be healthy and well. This can take some time. Workout gradually, and pay attention to what you're doing. The more you focus clearly on your activity, the more beneficial it will be for you, both physically and mentally. Sure, exercise is work, but it can also be a lot of fun - especially when you start noticing your clothes becoming looser. It's really fun when people stop to tell you how great you look.  And it's really fun when you realize that you have so much more energy than you used to and how much more you're enjoying your life!

Health insurance costs have been out of control for some time now. We're all painfully aware of this inflationary spiral. Monthly premiums are through the roof. Co-payments always seem to be on the rise, with out-of-pocket expenses that are so costly we might begin to wonder what we're saving by buying health insurance at all.

This is a burden we all share. For the self-employed, the monthly premiums for adequate individual health insurance are often $1000/month or more. Because of this, many small business owners, choose catastrophic coverage instead. Catastrophic policies will probably still cost $4000 - $5000 or more per year, and if you encounter medical problems, you could end up paying $5000 or more for out-of-pocket expenses.

Some savvy self-employed people combine a less expensive catastrophic (high-deductible) policy with a Health Savings Account (HSA) which allows them to save and use pre-tax dollars for health related expenses, included alternative and preventative treatments.

It is more important than ever for individuals and families to do what they can on their own to ensure better health. Improved health and well-being always translate into reduced health care costs.^1,2

Health-promoting lifestyle choices make a significant difference in both short-term and long-term well-being. Bad habits may need to be broken and replaced with new more positive habits. Nurturing good, healthy habits will pay dividends in better health, and will usually result in increased monetary savings by reducing your health care expenditures.

Nutrition and fitness are usually the main categories in need of improvement. Obesity, heart disease, chronic high blood pressure, and diabetes are a few of the main culprits that raise our national health insurance costs. Each of these can be positively impacted by engaging in regular exercise and improving your diet.

Other vitally important changes include stopping smoking, reducing alcohol consumption, drinking water instead of soda, reducing your snacking and portion sizes, and significantly reducing the consumption of processed foods - especially sweets and carbohydrates. Making all these positive changes, slowly over time, will improve your overall state of health.³

Think in terms of the long haul rather than short-term results. Lasting change is a process that doesn't happen overnight. Our goal is a lifetime of good health supported by good habits. Think about how you can make small changes, one at a time, that will become part of your long-term lifestyle.

It is also helpful to focus on what you are gaining, rather than what you are giving up.  For example, focus on preparing wonderful high-quality whole foods that are full of flavor rather than focusing on the less healthful foods you are giving up.  To successfully replace your habits with more healthful ones, make sure to frame things positively.  Instead of stuffing yourself with low quality purchased sweets that are filled with chemicals you can't pronounce, indulge your sweet tooth with one or two organic, dark chocolate truffles that are filled with antioxidants.  Eat slowly, chew your food well, and really allow yourself to enjoy your meals.  Become a picky eater - make an effort to choose high quality whole foods and small portions instead of larger quantities of junk food.  Chances are, you will learn to enjoy eating this way.

Chiropractic health care is an important part of the process of restoring well-being and reducing health care costs. Regular chiropractic visits can help a person stay active and are an important component in regaining your fitness. Chiropractic treatment helps to improve flexibility, stability and balance, which can increase your ability to exercise and make it more fun.

Your Millar chiropractor can be an invaluable resource as you work on improving your health. He or she will have many helpful recommendations regarding health-promoting nutrition and exercise, and will be happy to provide support and guidance in your journey back to good health.


¹Fronstin P: Health promotion and disease prevention: a look at demand management programs. EBRI Issue Brief 177:1-14, 1996
²Parks KM, Steelman LA: Organizational wellness programs: a meta-analysis. J Occup Health Psychol 13(1):58-68, 2008
³Pearce PZ: Exercise is medicine. Curr Sports Med Rep 7(3):171-175, 2008

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Herniated Discs & Back Pain

This is a repost from the Millar Chiropractic Website.

Herniated Discs & Back Pain

Lower Back and Leg Pain

Sciatica is the term used for pain that is caused by the compression or irritation of the sciatic nerve.  The pain radiates into the buttock and down the back of the thigh.  It may even radiate into the lower leg and foot. The pain may be accompanied by numbness, tingling and/or muscle weakness. Sciatica is most commonly caused by disc herniation. Sciatic type pain that travels into the buttock and the back of the thigh may also be caused by mechanical changes in the sacroiliac joint and the spinal joints of the low back. These mechanical changes relate to tight spinal muscles and inflamed tendons and spinal ligaments, with resulting loss of full mobility. Another cause of sciatic pain may be the compression of the sciatic nerve by the piriformis muscle in the buttock.  Piriformis syndrome and mechanical changes to the joints, muscles, tendons, and ligaments should be considered as a possible cause of sciatic pain once disc herniation has been ruled out. The good news is that chiropractic treatment can often be effective at treating these underlying structural problems, by restoring proper function and balance to the joints and soft tissues. When this is the cause of sciatica, symptoms will often begin to improve quickly with chiropractic care. Additionally, your chiropractor will likely recommend stretches and exercises to help resolve the problem and maintain physical health.

We have seen many patients over the years with herniated discs and low back pain.  A common scenario is that the person bends over to pick up something when they suddenly feel a sharp, stabbing pain in the low back. They may describe it as an electrical shooting pain in the lower back, so severe they had to sit down. The next day, they may notice pain and numbness radiating down one leg, and may have difficulty walking.

Why did this occur, and what can be done about it? Let's start with a very basic anatomy lesson. Spinal discs are weight-bearing shock absorbers. They contain a gel-like center, which is surrounded by tough fibrous cartilage, arranged in concentric, criss-crossing circles called the annulus fibrosis.¹

As a person ages, the water content of the discs naturally diminishes, and cracks and fissures begin to develop in the annulus fibrosis. If a weight-bearing stress is unusual and unexpected, the gel-like material in the center of the disc can protrude or extrude through one of the fissures and then, depending upon the location, may irritate a spinal nerve.

If enough of this material pushes through the annulus fibrosis, the nerve can become inflamed, resulting in symptoms such as radiating pain and/or numbness, and possibly weakness, in one leg.

In a typical case, this pain and/or numbness will radiate down the back of the leg, and may even travel into the lower leg and possibly into the foot.

These symptoms, with or without back pain, are highly suggestive of an inflamed spinal nerve. In fact, the person will often report that their leg symptoms are much worse and more concerning than any back pain they may have.

So, what happens if the MRI confirms the disc herniation and suggests an inflamed nerve?

In the best-case scenario, conservative treatment may be sufficient and the nerve inflammation improves with time.^2,3 Anti-inflammatory medication (or supplements containing natural anti-inflammatory ingredients such as boswellin, curcumin, cayenne and ginger) may be helpful. Chiropractic conservative therapy may include decompression traction (DTS) if indicated, along with other physical therapeutic modalities and gentle trigger point therapy to relieve associated muscle spasms.

A spinal surgeon should be consulted to provide an additional opinion and input. Depending upon the type and location of disc herniation, the severity of the pain, and whether or not there is neurologic loss, surgery may be the best option.

In many cases though, chiropractic care, including decompression traction (DTS), can be very effective in treating disc herniation.

Of course, the best management, as always, is prevention.  Always practice safe lifting procedures. Make sure you get regular exercise and sufficient rest. Regular preventative chiropractic adjustments will help minimize long-term stress on your discs by helping to maintain proper spinal alignment. Additionally, your chiropractor will be able to provide guidance and appropriate recommendations to help you attain and maintain good health and wellness.



¹Postacchini F: Lumbar Disc Herniation. Springer, 2004, Chapter 2.
²Rothoerl RD, et al: When should conservative treatment for lumbar disc herniation be ceased and surgery considered? Neurosurg Rev 25(3):162-165, 2002.
³Lumbar Disc Herniation. New Engl J Med 347(21):1728-1729, 2002.

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When Are Headaches More Than Simple Headaches?

This is a repost from the Millar Chiropractic Clinic website.

When Are Headaches More Than Simple Headaches?

Hypertension

Hypertension (high blood pressure or HBP) is a common unrecognized cause of headaches.  Hypertension itself is very common - according to the American Heart Association, approximately one-third of American adults have HBP. Nearly one-third of these people don't even realize that they have HBP. This is a serious problem. Two of the most important things you can do to prevent HBP are to make sure you get regular exercise, and to maintain a normal body weight. For extra benefits, exercise outside in nature whenever possible. This may help reduce stress (and therefore blood pressure) even more. Eating fresh, raw garlic has also been shown to help improve blood pressure.  If you (or your partner) objects to the garlic smell, you can take odorless garlic capsules instead. It is also helpful to make sure your vitamin D levels are sufficient.  You can have your doctor order an inexpensive test to make sure you are not deficient. Eating a lot of fresh, non-starchy vegetables is great, but make sure you don't overdo it on the fruits, especially if you tend to have HBP.  Fructose, the main sugar in fruit has been linked to elevated blood pressure. The even bigger culprit, however, is the high fructose corn syrup found in many commercial products... especially soft drinks.  These must be avoided, especially if you have HBP! It is also helpful to avoid coffee (which can increase blood pressure) and make sure you are getting enough sleep each night.

Did you know that approximately 10 million Americans suffer with daily headaches? 50 million more have headaches often enough to seek medical care, while approximately 23 million Americans suffer from migraines.  Although people spend billions of dollars each year on Imitrex for migraines, and various over-the-counter remedies for tension headaches, the statistics haven't really improved in the last 20 years.  Approximately one out of every six Americans suffers from headaches.

Tension headaches are the most common type of headache.  These are generally caused by stress and muscle tension (primarily in the neck and shoulders) but can also be caused by eye strain. The dull, throbbing pain can be severe, and may even include nausea.

Migraines are even more debilitating, and are often preceded by something called an "aura", referring to the visual symptoms which may include seeing flashing lights or even losing a portion of one's visual field.

Although headaches are a very common malady, they should never be taken for granted.  Everyone who suffers from headaches should, at some point, have a physical examination to rule out serious underlying problems such as high blood pressure.

It is also very important to realize that the occurrence of an unusual headache, accompanied by brand-new symptoms, should be immediately evaluated by a physician. A severe and sudden headache, "like nothing I ever had before", requires immediate attention. If you've never previously vomited as a result of a headache, and suddenly you are, you need to see a physician. An unusual, unexpected increased level of headache pain also requires immediate attention. Any of these situations could be the result of a serious underlying problem, and an MRI is usually necessary.

Chiropractic treatment is often a great benefit for many people who suffer from tension headaches and even migraines. A chiropractic physician will perform a complete physical examination, which often includes x-rays. Underlying causes of headaches must be ruled out. If a medical condition is indicated, the patient may be referred to the appropriate specialist.

Chiropractic spinal adjustments are a gentle procedure that effectively reduces muscle tension while improving spinal mobility.  With chiropractic care, neck and shoulder muscles are freed from being held in fixed positions, resulting in improved circulation, improved cellular nutrition, and more efficient muscle activity. The frequency and intensity of tension headaches may be noticeably reduced. Migraine headaches may also improve as well.

Regular exercise and an appropriate diet are also crucial in the treatment of headaches. Exercise improves all aspects of muscle function, while also improving circulation which helps your muscles by bringing oxygen and nutrients and removing irritants such as lactic acid.  Exercise also helps to improve a person's mood, and significantly reduces overall stress and tension.  An additional benefit of a balanced diet combined with regular exercise may include the loss of excess body fat, which reduces the mechanical stress caused by excess pounds.

Headaches are usually a sign that something is out-of-balance. Exercise, balanced nutrition, and chiropractic care can help restore balance to our highly stressed lives.



Source: National Headache Foundation - www.headaches.org

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Training Smart to Lower Your Risk of Injury

This is a repost from the Millar Chiropractic Clinic website.

Training Smart to Lower Your Risk of Injury

Visualization and Exercise

Visualization is an effective tool for creating the life you desire. It is also the key to making your workouts more beneficial. Visualization enhances the natural connection between your body and your mind. When you picture your muscles working in your "mind's eye", the "wiring" between your nervous system and your muscles increases. More nerve-muscle connections are created and enhanced, resulting in stronger and smarter muscles. It is really quite remarkable. And the nice part is that it doesn't take any extra effort, other than thinking about it!

Have you ever been out running when you suddenly experience pain in your shins?  Shin splints¹ are common in runners, but there are things you can do to lower your risk.


One thing you can do to lower your risk of injury is to make sure you have a plan for exercise. Having a well thought out strategy can help you train smart and train safe. When you train smart and follow your plan, then you can also train hard while minimizing your risk of injury.

Training smart and safe means paying attention to what is happening in your body as you workout. "Paying attention" is a learned skill that depends upon repetition and mental focus. Visualization is an important aspect of mental focus, and if you're visualizing ideal form while you're exercising, then you are automatically paying attention!

If you are a runner, you can focus on:
•    Visualizing a strong, fluid and erect spine, and a strong abdominal core.
•    Keeping your head upright, looking forward and slightly down, while keeping your chest open and relaxed.
•    Keeping your arms and shoulders relaxed while you move.
•    Visualizing a long, fluid stride with your feet landing gently, and then pushing off powerfully, as your leg extends behind you.

Training smart also involves trusting your instincts, instead of following your ego. This can be challenging for many of us. In the middle of a workout, it can seem imperative to complete your set and do that last rep even if your form is suffering. But the truth is, form is the most important thing.  If you end up sacrificing proper form to complete those last few reps, you may get an unexpected and unwelcome result.

It is the same for runners. If you are running and your form begins to break down, take that as a signal to lessen your speed enough to reestablish your good form. If you train while focusing on proper, effective form, you will be more likely to run a good race at a good pace when the time comes.

As in much of life, there is a sweet spot where you are training hard enough to get the results you're seeking, but not overtraining and increasing your risk of injury.  Remember, to pace yourself so that you continue to receive the benefits of training over the long term, rather than being side-lined by an injury.



¹Couture CJ, Karlson KA: Tibial Stress Injuries: Decisive Diagnosis and Treatment of "Shin Splints". Physician and Sportsmedicine 36(6):29-36, 2002 

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When Today's Fashion Becomes Tomorrow's Pain

This is a repost from the Millar Chiropractic Clinic website.

When Today's Fashion Becomes Tomorrow's Pain

Tips for Being Comfortably Fashionable

Choose a purse or briefcase that has a wide adjustable strap, long enough to wear across your torso. This helps to distribute the weight more evenly across the body. Keep your purse or briefcase as light as possible - take time to remove unnecessary items - and switch from side to side frequently to ease the burden. Try not to keep your wallet or card holder in your back pocket - especially when you are sitting or driving for extended periods of time. Wear comfortable shoes as much as possible. Wear flat shoes if you walk to work, and bring your heels with you. Keeping a comfortable lower-heeled pair at your office is helpful if your feet begin to bother you during the day. Be picky when shopping for shoes, and only buy them if they are very comfortable.  Look for shoes with lower heel heights. Your body will thank you. If possible, remove your heels and stretch your calves and hamstrings during the day. Avoid wearing excessively tight clothing.  If clothing is very form-fitting, make sure the fabric has some stretch. Consider your daily tasks, and if your clothing affects your movements in a negative way, consider outfits that will better fit your lifestyle.

Looking your best may not always be the best thing for your body. Today's society is generally very style and fashion conscious. The downside is that clothing designers and style professionals focus on creating visually interesting styles that can sometimes be impractical or even uncomfortable to wear.

Fashion shows typically feature models strutting down the runway in high heel stilettos and tight pants or skirts. These styles may look good on the catwalk, but in real life they are rarely practical and often result in back, foot, leg, neck or spine problems.  Many women are unaware of the adverse effects of wearing high heels, tight clothing, and carrying a heavy purse or briefcase.

Women often wear high heels to complement an outfit rather than for comfort, not realizing that high heel shoes can cause serious pain and problems in the feet and legs.  It can even cause or exacerbate back pain.

In a natural barefoot posture, the body's weight is properly distributed.  When a woman wears high heels, the position of the body is altered which causes shortening and tightening of certain muscles - particularly the hamstrings, and the gastrocnemius muscles of the calves.  It also causes increased stress and strain on your body while it struggles to adapt to an altered center of gravity.  Wearing high heels for an extended length of time increases the normal curve of the lower back, causing the pelvis to tilt forward. These changes are necessary for the body to maintain equilibrium while wearing high heels, but they are bad news for the musculoskeletal system.

Look for heels that are well-made, supportive, well-cushioned, and ideally less than 3 inches high.  Also, try to minimize the length of time heels are worn, and alternate them with good, supportive low heeled shoes.

Another major problem area when it comes to fashion is purses or handbags. Women often carry too many items in their purses, and are usually unaware of the potential health risks associated with lugging around too much "stuff."  When a women carries a purse or briefcase on one shoulder, she will unconsciously raise that shoulder and tighten her muscles in an attempt to keep it in place.  This throws off her body alignment and causes even more muscles to tighten in an attempt to balance this uneven weight distribution.  This can can cause chronic back pain, and an abnormal curvature in the spine.  When we see a patient who has been carrying her purse on one shoulder, it is usually very obvious due to the telltale postural issues and misalignments.

It is much better to use a purse or briefcase that has a strap long enough to be worn across the body, which distributes the weight more evenly.  It also allows your shoulder to relax more because you are no longer subconsciously tightening your muscles to keep it in place. The other important factor is the weight of your purse or briefcase.  Go through your bag regularly, removing anything that you don't absolutely need to carry each day.  Even with the bare minimum though, your purse or briefcase can still be a significant burden, especially if you are carrying it for an extended length of time. Also, get in the habit of switching your purse or briefcase from one side of the body to the other, to keep your body more balanced.

Both men and women are susceptible to the influence of fashion. However, women are much more likely to wear clothes that are too tight. A tight pencil skirt or tight jeans can be attractive on some women, but they can also make it more difficult to sit, walk or bend. This will usually have a negative effect on posture, and can cause or exacerbate spinal misalignments.

The main problem area for men is that they often carry their wallets or cardholders in the back pocket of their pants. This can be convenient, but carrying your wallet in the back pocket of your pants can throw your body off balance when sitting for an extended period of time.  Make a point of switching your wallet to your front pocket if you know you will be sitting or driving for a while.

Stylists and designers are often more concerned about the way something looks rather than the effect it has on the body. Pay attention to the way your body feels.  It's nice to look fashionable, but it's more important in the long run to select shoes, bags and clothes that not only suit your style and lifestyle, but are also comfortable.  Besides, feeling good will make you look even better as your natural health and vitality shines through.  By following these simple suggestions, you can be fashionable while still being comfortable, and feel as great as you look.

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Things You Need to Know About Lab Tests

This is a repost from the Millar Chiropractic Clinic website.

Things You Need to Know About Lab Tests

Analyzing Lab Tests

Various aspects of health care have made significant advances in the last few decades . Laboratory testing has also improved, not only in the range of tests available, but also in the quick turnaround-time of results. Unfortunately though, no lab test is perfect. Tests may either inaccurately suggest that a patient has a particular disease they don't have, or instead miss the presence of the disease in someone who actually has it. Either of these situations can be very problematic. MRIs, for example, are a helpful tool that reveal more information than ever before. But not every suspicious shadow on an MRI means something. It takes time and experience to accurately interpret MRI images. It is not unusual for new technology to become available well in advance of our ability to accurately interpret the results. Lab tests need to be interpreted cautiously. In order to have an accurate diagnosis, we need to also have supporting evidence in the form of patient history and physical exam findings, in addition to the lab test results.

You're in your doctor's office because you noticed some unusual symptoms and are afraid something might be wrong. Even though you know some lab tests are probably necessary, that doesn't prevent you from feeling anxious. We may want to know the results, but at the same time we probably are very concerned about what the outcome might be. Hearing the doctor casually mention that "we need to do some blood work," can be enough to trigger a strong bout of anxiety in many people.

Then when you get the results, it can be difficult to decipher the medical jargon, especially when the tests are "positive". Most of us have had the experience of our mind tuning out after hearing the initial news that "your test results are positive".  In this situation, our minds begin racing ahead, imagining all sorts of awful possibilities.

Occasionally, a compassionate physician will endeavor to put the lab results in a less-worrisome perspective for the patient. For patients, it helps to know some important facts  that will help to empower you whenever you have lab tests done.

First of all, statistically one out of every 20 tests performed will be reported as "abnormal", even though the result is in fact "normal" for the individual being tested. If you are perfectly healthy and have 20 tests done on your blood sample, one of those 20 test results will be "out of the normal range" based on statistics alone.¹

This anomaly is a result of the way the normal test range is calculated, which involves testing a large group of "normal" people and eliminating the top and bottom 2.5% of the results, leaving the middle 95% as the normal range. So if 20 tests are done, statistically one will be considered "abnormal", only because its results will fall in the top or bottom 2.5%.  It may be perfectly normal for you, but it will still be reported as "abnormal".

Other things to consider are the specificity and the sensitivity of the lab test.²  Specificity has to do with whether or not a particular positive test result actually indicates the presence of the disease for which you are being tested.  If a test has a specificity rate of 90%, then in ten out of 100 positive results, the patient does not actually have the disease. Sensitivity has to do with how accurate the test is in detecting the disease when the disease is truly present. For example, if a test for colon cancer is 90% sensitive, it will miss ten cases of the disease out of every 100 cases.

To summarize, if a test has low specificity, test results reporting the presence of the disease may be inaccurate, and if a test has low sensitivity, actual cases of the disease may be missed. All these factors need to be taken into consideration when interpreting lab test results. Things are not always as they seem.³

The important thing to realize from all of this, is that lab test results should always be evaluated in the specific context of the patient. An isolated lab test result - or a set of lab test results - needs to be related to the patient's circumstances and condition.  Making a diagnosis based on lab results alone can be a big mistake.

Similarly, x-ray, MRI, and ultrasound results must also be interpreted in context. Attempting to interpret an x-ray without any clinical information will likely result in an inaccurate conclusion. Context is everything. Your doctor should be willing and able to explain why certain tests are necessary, and to help you understand what the results indicate, when taken into consideration along with your exam and other findings.



 
¹Thomas SL, et al: How accurate are diagnoses for rheumatoid arthritis and juvenile idiopathic arthritis in the general practice research database? Arthritis Rheum  59(9):1314-1321, 2008
²Friston KJ, et al: Classical and Bayesian inference in neuroimaging: theory. Neuroimage 16(2):465-483, 2002
³Kobayashi M, et al: Intraindividual variation in total and percent free prostate-specific antigen levels in prostate cancer suspects. Urol Int 74(3):198-202, 2005

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