The Shifting Sands of “Normal”: When lab Ranges Create Patients
The world of medical diagnostics is built on numbers, but those numbers aren’t immutable truths. A quiet shift is happening in labs across the country – a recalibration of what’s considered “normal” – adn it’s creating a wave of unneeded anxiety and expense.
Just this week, one lab quietly adjusted its Apolipoprotein B (ApoB) reference range. A patient whose ApoB of 98 mg/dL was perfectly acceptable on Monday was flagged as “high” on Tuesday. No new research, no public health emergency, just a change in the lines drawn around the statistical average. And with that, millions could find themselves reclassified as “abnormal” overnight.
These reference ranges are simply statistical boundaries, defining the middle 95% of a reference population. They have no inherent connection to actual health risks like heart attacks. ApoB is a useful marker for assessing risk, but that risk is gradual, not a sudden cliff edge triggered by
