Why your blood tests can be ‘normal’ and you still feel awful

You’ve had the blood tests.
Your doctor says everything looks normal.
But you’re still exhausted, bloated, anxious, breaking out, losing hair, or struggling with your cycle.

This is one of the most common and frustrating experiences I see in clinic , and it doesn’t mean your symptoms are imagined or that “nothing is wrong.” It usually means we’re asking the wrong question.

The problem with the word “normal”

In conventional medicine, blood test reference ranges are created by averaging results from a large population.

That population includes people who are:

chronically stressed
under-slept
inflamed
hormonally dysregulated
nutrient depleted

So when we say a result is “normal,” what we often mean is you’re not sick enough to diagnose, not that your body is functioning optimally.

You can be within range and still:

not ovulating well
struggling to make hormones efficiently
running on empty
compensating under chronic stress

Symptoms usually appear long before pathology does.

Normal vs optimal: a simple example

Take iron.
Many labs list ferritin as normal anywhere from very low to quite high. But clinically, many people , especially menstruating women , feel significantly better when ferritin is well above the lower end of that range.
From a TCM perspective, iron deficiency often overlaps with Blood deficiency, which can show up as:

fatigue
poor sleep
anxiety
hair shedding
light or irregular periods

You don’t need to be “anaemic” to feel the effects of depleted Blood.

What TCM is looking at instead

Traditional Chinese Medicine doesn’t wait for disease to show up on a lab report.
It looks at function, patterns, and trends.
We ask:

How is the body coping?
Where is it compensating?
What systems are under strain?

Two people can have identical blood results and completely different TCM diagnoses , because their patterns are different.
Symptoms are data

In TCM, your symptoms are not annoying side notes. They are information.
Things like:

waking at 3am
feeling wired but exhausted
digestive changes around ovulation
temperature sensitivity
emotional volatility before your period

These help us understand whether the issue is rooted in:

Qi stagnation
Blood deficiency
Yin depletion
hidden heat or inflammation
digestive weakness

None of these will necessarily show up on standard blood work , but they absolutely affect how you feel.
Why I often ask to see blood tests anyway
Even though TCM doesn’t rely on labs, I often ask patients to bring them in.
Not to override Western medicine , but to layer information.

Blood tests can:

confirm trends we already see clinically
rule out red flags
show where the body is under long-term strain

When we look at labs through both lenses, we get a much clearer picture than either system alone.
Healing happens upstream
By the time something is clearly “abnormal” on a test, the body has often been struggling for years.
TCM works upstream , at the level of imbalance , before it becomes disease.
That’s why treatment often focuses on things like:

regulating digestion
supporting sleep and the nervous system
improving circulation and blood flow
restoring hormonal communication

These shifts may not immediately change a lab value , but they change how you feel.
If you’ve been told “everything looks fine”, and yet you know in your body that something isn’t right, trust that instinct.

Feeling awful with normal blood tests doesn’t mean you’re broken. It means your body is asking for support earlier than modern diagnostics are designed to listen. And that’s exactly where Chinese medicine excels.

– Adriana