The Optimisation Gap: Why 'Normal' Blood Work Keeps You Mediocre

The Problem with "Normal"

Last month, a 39-year-old tech founder walked into our partner clinic. He was training 5 times per week, tracking his macros, sleeping 7 hours a night. His GP told him his testosterone was "normal" at 380 ng/dL.

But he felt like garbage. Energy crashed by 3pm. Recovery took twice as long as it used to. Brain fog made afternoon meetings a struggle. His libido was non-existent.

His doctor said everything was fine. The blood work was "within range."

Here's the problem: those ranges are designed for the general population — which, statistically, is sedentary, overweight, and chronically ill. Being "normal" simply means you're not dying. It doesn't mean you're thriving.

Survival Zone vs. Optimization Zone

Standard medical reference ranges exist to identify disease, not optimize performance. They're based on the 95th percentile of the tested population, which includes:

Sedentary individuals with poor lifestyle habits
People with undiagnosed chronic conditions
Older populations (skewing averages downward)
Those on multiple medications affecting hormone levels

A testosterone level of 350 ng/dL might be "normal" for a 65-year-old sedentary man. But for a 38-year-old founder working 70-hour weeks, training hard, and trying to build a business? It's a performance killer.

The Optimization Zone

Functional medicine and optimization clinics focus on what's optimal, not just normal. For testosterone, this typically means:

Ages 30-40: 600-900 ng/dL (optimal for performance, recovery, cognition)
Ages 40-50: 500-800 ng/dL (maintaining vitality and muscle mass)
Ages 50+: 450-700 ng/dL (longevity and quality of life focus)

These aren't arbitrary numbers. They're based on research showing peak performance, body composition, cognitive function, and overall wellbeing.

The 5 Biomarkers Your Standard Panel Misses

Most GPs order a basic metabolic panel and call it a day. But if you're serious about optimization, you need to test:

1. Free Testosterone (Not Just Total)

Total testosterone includes both bound and unbound hormone. Only free testosterone is biologically active. You can have "normal" total T but low free T — meaning you're not getting the benefits.

2. Estradiol (E2)

Men need estrogen for bone health, libido, and cardiovascular function. But too much (often from aromatization of testosterone) causes water retention, mood swings, and gynecomastia. Optimal range: 20-30 pg/mL.

3. SHBG (Sex Hormone Binding Globulin)

SHBG binds to testosterone, making it unavailable for use. High SHBG = low free T, even if total T looks good. This is common in stressed, high-performing individuals.

4. Thyroid Panel (TSH, Free T3, Free T4, Reverse T3)

Your thyroid controls metabolism, energy, and body temperature regulation. Most GPs only test TSH, which misses subclinical hypothyroidism. You need the full panel.

5. IGF-1 (Insulin-like Growth Factor 1)

IGF-1 is a marker of growth hormone production. Low IGF-1 = poor recovery, muscle loss, and accelerated aging. Optimal range: 200-300 ng/mL for men over 30.

Case Study: From "Normal" to Optimal

Back to our tech founder. After a comprehensive panel at our partner clinic (Biov8), here's what we found:

Total Testosterone: 380 ng/dL (normal, but suboptimal)
Free Testosterone: 7.2 pg/mL (low — should be 15-25)
SHBG: 62 nmol/L (high — binding too much testosterone)
Estradiol: 45 pg/mL (elevated)
Free T3: 2.8 pg/mL (low-normal, explaining fatigue)

His GP would have sent him home. "Everything's normal."

Instead, the specialist prescribed:

Low-dose testosterone replacement (100mg/week)
Anastrozole (0.25mg 2x/week to manage estradiol)
Thyroid support (T3/T4 combination)

Six weeks later:

Total Testosterone: 720 ng/dL
Free Testosterone: 18.5 pg/mL
Estradiol: 28 pg/mL
Energy levels: "Best I've felt in 10 years"
Recovery: Training 6x/week without burnout
Cognition: "Afternoon meetings are sharp again"

How to Advocate for Better Testing

If you want to optimize, not just survive, here's what to do:

1. Request a Comprehensive Panel

Ask your GP for:

Total and Free Testosterone
Estradiol (sensitive assay)
SHBG
LH and FSH (pituitary function)
Full thyroid panel (TSH, Free T3, Free T4, Reverse T3)
IGF-1
Vitamin D, B12, Ferritin
Lipid panel (including ApoB)
HbA1c and fasting insulin

2. Test in the Morning

Testosterone peaks in the morning (7-9am). Testing in the afternoon will give falsely low readings.

3. Get a Second Opinion

If your GP dismisses your concerns, seek out a specialist. AHPRA-registered clinics like Biov8, Longevity Clinics, or telehealth providers specializing in men's health understand optimization.

4. Track Symptoms, Not Just Numbers

Blood work is a snapshot. How you feel matters. Track:

Energy levels (morning, afternoon, evening)
Recovery time after training
Sleep quality
Libido and sexual function
Cognitive performance (focus, memory, decision-making)

When to Seek Specialist Care

You should consider consulting a hormone specialist if:

Your GP says you're "normal" but you feel terrible
You have multiple symptoms of low testosterone (fatigue, brain fog, low libido, muscle loss)
You're over 35 and noticing a decline in performance
You've optimized lifestyle (sleep, diet, training) but still plateau
You want to proactively optimize for longevity

How Varney Can Help

Varney connects you with AHPRA-registered specialists who understand the difference between "normal" and "optimal." Our partner clinics offer:

Comprehensive hormone panels (not just basic blood work)
Telehealth consultations (no need to visit a clinic)
Personalized protocols based on your goals
Ongoing monitoring and adjustment

Take our 2-minute assessment to see if you're a candidate for optimization.

The Bottom Line

"Normal" is designed for survival, not performance. If you're a high-performing individual — founder, executive, athlete — you deserve better than average. You deserve optimal.

Don't settle for "fine." Demand better.