The Dr. Hyman Show
Office Hours: The Blood Tests That Actually Matter for Your Health
Host: Dr. Mark Hyman
Date: February 23, 2026

Episode Overview

In this solo “Office Hours” episode, Dr. Mark Hyman tackles a common frustration in conventional healthcare: patients feeling unwell but being told their bloodwork is “normal.” He demystifies why standard lab test ranges fail to capture early dysfunction and guides listeners in using the right blood tests to empower and optimize their health. Dr. Hyman explains the limitations of annual checkups, makes the case for more comprehensive, data-driven, and frequent lab testing, and gives a step-by-step breakdown of the biomarkers that genuinely predict—and help prevent—chronic disease. He also describes the paradigm shift from “normal” to “optimal” ranges, and why being proactive with personal health data is foundational to longevity and vitality.

Key Discussion Points & Insights

The Broken Model of “Normal” Lab Ranges ([00:56]–[12:35])

• Common Scenario: Many patients are told their labs are normal despite ongoing symptoms. Dr. Hyman argues that this means something is being missed.
• Why Normal Isn’t Optimal:
  • Lab reference ranges reflect statistical averages, not what’s healthiest.
  • “If you were to land in America and ask what’s the ‘normal’ weight, you’d see it’s overweight—because 75% of us are. It doesn’t mean it’s right or healthy.” ([10:34])
• The Continuum of Disease:
  • Disease develops gradually, often before overt symptoms or abnormal labs.
  • Doctors often look for acute disease rather than subtle, cumulative imbalances.
• The FLC Syndrome:
  • Many accept feeling like crap (FLC) as normal—headaches, joint pain, fatigue, IBS, etc.—but these are often signs of hidden imbalances.

Notable Quote

“Lab tests are powerful tools for understanding what’s going on underneath the hood in your body. Disease doesn't just happen from one day to the next. You get sick slowly, invisibly, until one day you have symptoms and eventually get a disease.”
— Dr. Mark Hyman ([02:30])

The Power of Comprehensive, Proactive Testing ([08:30]–[13:45])

• Limitations in Conventional Testing:
  • Annual checkups often measure only ~20 markers, catching abnormalities only when disease is advanced.
  • Insurance and healthcare systems resist deeper, proactive testing.
• Importance of Longitudinal Data:
  • Regular, comprehensive labs (not once a year) catch early dysfunction and “tune up” health, analogous to maintaining a car.
• Personal Ownership:
  • Having access to and understanding your own lab data is fundamental to being CEO of your own health.

Notable Quote

"The annual checkup, as is currently done, has been scientifically shown to be pretty much useless... You want to look deeper, track things over time, and stay ahead of the problem."
— Dr. Mark Hyman ([05:25])

What Labs Actually Matter: The Core Biomarker Categories ([18:30]–[44:00])

Dr. Hyman breaks down the tests that provide the greatest insight for prevention, longevity, and optimization.

1. Metabolic Health ([19:12]–[21:58])

• Key tests: Fasting glucose, fasting insulin, and hemoglobin A1C.
• Why important:
  • Early metabolic dysfunction underpins most chronic illness (diabetes, heart disease, cancer, dementia).
  • Insulin is often the first to become abnormal—long before glucose and A1C.
• Optimal ranges:
  • Fasting glucose: 70–85 mg/dL (not the broader reference up to 100).
  • Insulin: <5 μIU/mL preferred (labs may say up to 18 is “normal”).
• Symptoms of dysfunction: Belly fat, sugar cravings, crashes after meals, brain fog.

“You can have normal blood sugar but high insulin—your doctor misses it, but you’re on the path to trouble.”
— Dr. Mark Hyman ([20:30])

2. Inflammation Markers ([22:15]–[25:32])

• Key tests: hsCRP (high-sensitivity C-reactive protein), ferritin, blood count (white cells).
• Why important:
  • Chronic, low-grade inflammation is a root cause for heart disease, diabetes, obesity, dementia—nearly all conditions of aging.
  • Many feel vague aches, fatigue, or fog—silent inflammation may underlie these.
• Identifying source matters: Diet, toxins, microbiome, allergens, chronic infection.

“The hallmark of aging is ‘inflammaging.’ If we figure out the cause of inflammation, we can get it sorted—and change your long-term risk.”
— Dr. Mark Hyman ([24:55])

3. Cholesterol and Lipid Particles ([25:35]–[29:18])

• Beyond standard cholesterol:
  • Particle size and number are crucial—a person can have “good” cholesterol numbers but bad particle profile.
  • Key overlooked markers: ApoB (total number of atherogenic particles), Lp(a) [lipoprotein little a, a genetic risk factor].
• Heart disease risk is often hidden:
  • First symptom for half of heart attack victims: sudden death.
  • Early, advanced cholesterol testing can identify risk years in advance.

“You can have normal cholesterol and still be at serious risk. The most important tests are missing—like ApoB, which most doctors never run.”
— Dr. Mark Hyman ([27:40])

4. Thyroid Function ([29:20]–[32:52])

• Comprehensive testing needed:
  • Most doctors only check TSH. Dr. Hyman advises checking free T3, free T4, reverse T3, and thyroid antibodies.
• Optimal vs. normal:
  • Lab “normal” range for TSH is 0.5–5; optimal is closer to 1–2.
• Symptoms of dysfunction often missed: Fatigue, cold intolerance, dry skin, subtle mood or metabolic symptoms.
• Autoimmune thyroid issues are common and underdiagnosed.

“13% of our Function Health members have elevated thyroid antibodies—they didn’t know they had them… subtle symptoms dismissed as ‘normal.’”
— Dr. Mark Hyman ([31:21])

5. Nutrient Status ([32:53]–[35:45])

• Rarely checked in conventional care:
  • Vitamin D, B12, folate, ferritin, iron, zinc, magnesium, omega-3s.
• Deficiencies can underpin mood issues, fatigue, skin/hair problems, immune weakness, etc.
• Key for optimal metabolism and cellular function:
  • “37 billion trillion chemical reactions every second—each needs a vitamin or mineral to run properly.”

“Every cell in your body runs on chemical reactions, every enzyme needs a helper—the vitamins and minerals.”
— Dr. Mark Hyman ([34:41])

6. Gut-Related Markers & Integrative Patterns ([35:46]–[37:55])

• Signs of poor absorption or inflammation (iron, B12, elevated LFTs) often dismissed as IBS or stress.
• Gut issues can drive systemic symptoms, including mood and inflammation (“body-mind effect”).

Why “Tracking Over Time” Is Everything ([37:56]–[41:13])

• Single labs give a snapshot; repeated measurement detects trends and early subtle decline.
• Functional Medicine Approach:
  • Patterns and relationships between multiple markers are more revealing than isolated results.
  • Your “normal” may differ from others—track your baseline and changes from it.

Notable Quote

“When I read a lab, I look for subtle patterns… If your blood sugar is 95, insulin a bit high, triglycerides rising—those are clues things are going off the rails LONG before you’re diabetic.”
— Dr. Mark Hyman ([40:13])

How to Approach Your Own Testing ([41:14]–[44:45])

• Be Informed, Not Passive:
  • Always get a copy of your labs; ask for the raw results.
• Compare to Optimal, Not Just Reference:
  • Use sources that provide both standard ranges and optimal targets for each biomarker.
• Test Regularly:
  • Once or twice a year at minimum; frequency might increase based on personal risks and patterns.
• Personalize & Be Proactive:
  • Use your historical trends to raise concerns or prompt changes—don’t rely on “you’re normal” dismissals.
  • Leverage platforms that combine labs, wearables, history, and “medical intelligence” for actionable insights.

"Labs aren’t just for diagnosing disease—they’re a roadmap for optimizing your future health."
— Dr. Mark Hyman ([43:21])

Memorable Moments & Quotes

• “We don’t want to guess—we want to test. Test, don’t guess.” ([10:50])
• “It’s not pre-diabetes or pre-hypertension—it’s EARLY dysfunction along a continuum. Catch it early and reverse the whole process.” ([13:40])
• “Half of people with heart disease experience sudden death as their first symptom. Don’t wait.” ([28:10])
• “I want you to get curious about your own data, look at labs with fresh eyes, start to connect the dots in your own health story.” ([44:34])

Action Steps and Takeaways

• Track These Core Lab Panels:
  • Metabolic: fasting glucose, insulin, A1C
  • Lipid panel with particle data (ApoB, Lp(a))
  • Inflammation: hsCRP, ferritin, white count
  • Comprehensive thyroid: TSH, free T3/T4, reverse T3, antibodies
  • Nutrient status: Vitamin D, B12, folate, iron studies, magnesium, omega-3s
• Monitor Over Time: At least 1–2 times per year; focus on trends, not snapshots.
• Be the CEO of Your Own Health:
  • Get your data; push for comprehensive testing; compare to optimal, not just “normal.”
  • Understand subtle patterns and address early dysfunction to prevent chronic disease.
• Share the Episode:
  • Especially with loved ones frustrated by “normal labs” but not feeling well.

Timestamps of Important Segments

• [00:56] “Everything’s normal, but you’re not fine”—introducing the main problem
• [10:34] The myth and danger of ‘normal’ lab reference ranges
• [18:30] Core categories of essential lab tests—listing begins
• [19:12] Metabolic health markers explained
• [22:15] Inflammation markers and silent disease
• [25:35] Advanced cholesterol and heart disease risk testing
• [29:20] Thyroid panel—what most doctors miss
• [32:53] Nutrient status testing and why it matters
• [35:46] Gut-related labs and the whole-system view
• [37:56] The importance of tracking labs longitudinally
• [41:14] How to approach and interpret your labs for optimization
• [43:21] “Labs as roadmaps, not just diagnoses”

Conclusion

Dr. Hyman closes with a call to action: don’t just accept “normal” as healthy—be proactive, own your lab data, and optimize your wellbeing through deeper, more insightful testing. He encourages listeners to view their health as a lifelong project, demanding ongoing curiosity, agency, and the right information.

“Remember: you are the CEO of your own health. Every choice you make can move you closer to healing and vitality.”
— Dr. Mark Hyman ([44:45])