Measured One at a Time, Everything Is Normal

Many people come holding their test results and say the same thing. Every item is normal, they are told, and yet the body stays heavy.

I do not hear that as a contradiction. Being normal measured one at a time, and feeling well, are two different matters.

A test measures one thing at a time

A test takes one thing apart and measures it. That is what makes measurement possible — how much of some component is in the blood, how thick a given place is. Without taking it apart, no number comes out.

And there is a line dividing that number into normal and abnormal. That line is usually set by gathering healthy people, measuring them, and taking the range most of them fall into. It is called a reference range.

There is nothing wrong with this method. Measuring one thing precisely requires exactly this.

But the body does not tilt one thing at a time

What I mostly see in the consulting room is this: not one thing far out of range, but several sides leaning a little in the same direction.

Water balance runs a little dry, circulation slows a little, muscle tension sits a little high, sleep grows a little shallow. Taken one at a time, none crosses a line. But these are not strangers to one another. When one leans, the rest follow a little that way.

Taken alone, each looks beside the point. If you ask what a slightly shallow sleep amounts to, there is no answer. It changes once you see that it faces the same way as four other things.

Medicine already contains this way of looking

This is not a view I invented.

Waist circumference, blood pressure, blood sugar, triglycerides, good cholesterol — these five are read together and called metabolic syndrome. What matters here is that the threshold for each item is lower than the line that would diagnose the disease on its own. The blood pressure is a value you would not call hypertension; the blood sugar is a value you would not call diabetes. Yet when several such values gather, they are given a name and managed.

This is a place where medicine has already built "each is normal, together they are not" into its own institutions. I simply extend that way of looking beyond those five items.

So what do I look at

I do not look first at whether any one thing has crossed a line. I look at which way they are leaning together.

Where several lean the same way, I work toward turning that direction back — not pushing one thing hard, but returning several places a little. It comes from the same ground as A Test Looks at the Body of That Moment. If Your Blood Sugar Is Borderline — I Look at the Swing First follows the same thought: before asking whether a number has crossed a line, ask which way it is moving.

When to be seen first

That said, "each one is normal" does not mean tests can be skipped. If weight falls on its own, if a fever lasts, if a symptom appears that was never there — examination comes before this conversation. And symptoms that persist do eventually show up in tests.

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I have carried a single sheet of test results this far.

What Korean medicine has long done is exactly this: not measuring one item, but seeing which way the whole has tilted. Taking the pulse, palpating the abdomen, looking at the tongue — none of it is an attempt to produce a value; it is an attempt to read a direction.

I do not think of that as competing with testing. A test measures one place precisely; an examination reads the direction of several. They see different things, so use both.

Sometimes the direction is visible before any number crosses a line. That is the place I look.

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Sources

• An account setting out metabolic syndrome as a cluster of five items, managed together at thresholds — blood pressure 130/85, fasting glucose 100 — lower than those that would diagnose each disease alone — Endotext, 2019

Written by Dr. Heo Ji-young (Ph.D. in Korean Medicine Pathology, Kyung Hee University · former Research Professor of Herbology, Kyung Hee University)