Everyone wants to do well on a test, but there’s no need to study for routine lab work. However, you should be examining the diagnostic lab test results with your medical team. Older adults and people of color may need to look beyond the “normal” range of routine or diagnostic lab results to find their own version of normal.
Routine testing is important to get the care you deserve. Minorities in particular may not get tested early or often enough to discover conditions that have few or no symptoms. However, family history and lifestyle offer important clues to your risk for many diseases. This health history helps doctors decide what screening tests may be needed and how often. So it does help to come to a doctor’s appointment knowing whether chronic conditions such as osteoporosis, diabetes or heart disease run in your family.
Blood tests take a small sample with a syringe and send it to a lab to look for specific proteins, fats or other elements in the blood. Some tests require fasting or holding up on caffeine or alcohol. Otherwise, follow your typical eating and exercise routines. Like flu shots, there’s a needle involved, but many people find the most painful part is waiting for their turn at the lab. Mention any past discomfort, so the person drawing blood can try a different technique or make you feel more at ease.
Grading the Test: Race Correction in Medicine
Next comes decoding the results to see what’s normal for you. The readings come with a sample reference range of scores. Often, the reference intervals come from medical trial results graded on the curve—the highest and lowest scores get dropped, so that 1 in 20 tests are out of range. However, trial subjects for years have typically been young, white and male. Doctors no longer assume that a diverse sample would have the same results.
In fact, medical research finds that different ages, genders or races have different ranges of lab results. One researcher, Dr. Tim Amukele at Johns Hopkins, himself had seemingly scary low white blood cell counts as a teenager, a frequent result in the Black community. Amukele identified a dozen substances that could produce misleading results for at least 1 in 10 Black patients. Questionable indicators included two markers of kidney function in the basic metabolic panel of tests: blood urea nitrogen and creatinine.
How does the medical community interpret such results? For many tests, labs assign different ranges of normal results based on demographics as well as medical factors. But while age or gender can explain differences in how bodies work, it’s another thing to assume that Black bodies somehow are different. As a result, these race corrections can cause doctors to either overlook or overreact to trouble signs. In 2021, guidelines on kidney function changed to drop race from the calculation, out of concern that kidney disease was going untreated. High blood pressure is common among Black Americans, but research questions whether race should determine what drugs to prescribe for the condition.
Doctors instead may not settle for a single test in their treatment choices. For example, blood sugar monitors give people with diabetes and their medical team more information beyond what blood tests alone tell them. Many people of African, Hispanic and Asian heritage get falsely high or low results in the A1C blood tests that those with diabetes must take every few months. The genetic sickle cell trait, which many people of color inherit, affects several methods labs use to measure A1C. Continuous glucose monitors, worn on the upper arm, give real-time cellphone readings that give doctors and patients more information to discover their own healthy blood sugar range and stay within it.
Research studies now include a more diverse group of patients. When they look into the differences they see in the Asian, Black and Hispanic populations, they’re finding that diseases have many causes and minorities share less genetic differences. The findings suggest that doctors have many factors to track down in their diagnoses. Patients can help by asking more questions about their results and giving medical providers more feedback about their medication results and lifestyle habits. In this way, patients can get more targeted treatment based on a holistic look at their condition and not just their ethnicity.