Guides for practitioners reviewing client lab work

Written by Alina Radu, founder of Sera. Each guide answers one question about working with clients' lab results, with the sources for every number linked.

• Spreadsheet or software for tracking client labs?

  When a spreadsheet is enough for tracking clients' blood work, a layout you can copy, where it breaks, and what to check before paying for software.

• Where do "optimal" lab ranges come from?

  The kinds of source behind a lab range, how to tell which one a chart is using, and worked examples for vitamin D, TSH and ferritin.

• Reference range or optimal range: what a "normal" result does and doesn't tell you

  How lab reference intervals are built, why they differ between labs, what a narrower optimal target adds, and where its evidence is thin.

• Comparing a client's results from different labs and units

  Which lab units are the same number, which need a conversion factor, why labs print different intervals, and when two results can't be compared.

• Building a new client's lab history before the first consultation

  What to ask a new client for, how to date and label each lab report, what context to record per draw, and how to spot the gaps before you meet.

• How often to retest common markers

  Retest intervals for TSH, free T4, TPO antibodies, ferritin, vitamin D, B12, HbA1c and lipids, from NICE, ADA and others, and which are convention.

• Did it work? Reading a marker before and after a change

  Why one retest can mislead after a diet or supplement change, how normal variation works, when to recheck, and what to record with each draw.

• Explaining lab results to clients within your scope of practice

  The line between educating and diagnosing, example wording for a high, a low and a borderline result, when to refer, and what to write down.

• What to do with lab results clients bring from direct-to-consumer tests

  How to check a self-ordered lab panel: what was measured, which lab ran it, units, reference intervals and missing context, then add it to the history.

• Reading thyroid labs over time: TSH, free T4, free T3 and antibodies

  What each thyroid marker adds, why one TSH result says little on its own, how antibodies are usually followed, and what to record with each draw.

• Reading a client's blood work over years, not one panel at a time

  Why a series of results shows slow drifts that one panel hides, how to line up years of results from different labs, and what to record with each draw.

• Keeping blood work and functional tests in one client record

  Why stool, urine, saliva and breath test reports belong in the same record as blood work, what to record with each one, and how to line them up in time.

• Why one marker rarely tells the story: iron as an example

  Why a ferritin read alone can mislead, and how transferrin saturation, serum iron, TIBC, hemoglobin and hsCRP from the same draw change the picture.

• Using AI on client lab reports: what to check

  Where AI helps with lab reports and where it doesn't, the checks to run on every value it reads, and the privacy questions to ask any tool first.

• A lab review clients can read: what to put in the client report

  What a client lab report should contain, from dates and units to labeled ranges and next steps, in wording that educates without diagnosing.

• Why practice software doesn't handle lab work well, and what to add

  What practice management software does well, what lab review needs that it usually lacks, and how to run a lab tool beside it without keeping two records.