574. The TRUTH About Your Labs: What Your Doctor Isn't Telling You with Dr. Ken Berry

Podcast Summary: The Thyroid Fixer – Episode 574

Title: The TRUTH About Your Labs: What Your Doctor Isn't Telling You with Dr. Ken Berry
Air Date: October 31, 2025
Host: Dr. Amie Hornaman
Guest: Dr. Ken Berry (Author, Family Physician, Health Educator)

Episode Overview

This episode dives deep into the realities of lab testing for thyroid and metabolic health, challenging conventional medicine's approach to "normal" lab values and one-size-fits-all medicine. Dr. Ken Berry joins Dr. Amie Hornaman to discuss his new book, Common Sense Labs, advocating for patients to understand and advocate for optimal—not just normal—lab results. The discussion covers why symptoms matter just as much as labs, how lab reference ranges are set, the influence of pharmaceutical industry guidelines, key tests for thyroid and metabolic health, and powerful strategies for patient self-advocacy.

Key Discussion Points & Insights

1. The Limitations of Conventional Medicine and Lab Ranges

Timestamps: [07:27]–[09:11], [14:23]–[16:33]

Conventional doctors often focus more on impressing patients or following systemized routines than actually listening and communicating actionable information.
Many lab reference ranges are based on outdated cohorts (often unhealthy, average Americans from decades past) and may reflect what’s “normal for a sick population,” not optimal health.
Dr. Berry emphasizes,

“The patient's symptoms are just as important, if not in many cases more important than the lab results.” ([10:17])
Labs are most useful when combined with detailed symptom histories; dismissing symptoms in favor of “normal” labs is a red flag.

2. How Lab Reference Ranges are Defined (And Why They’re Flawed)

Timestamps: [14:23]–[16:33]

Labs like LabCorp and Quest determine ranges by sampling 100–500 “healthy-appearing” people, finding a statistical average, and setting reference limits.
Most reference ranges come from people eating the Standard American Diet and may skew toward unhealthy baselines.
Dr. Berry:

“That is normal for a sick population, but it is not normal and indeed very not ideal if you’re trying to achieve optimal health.” ([16:11])
Functional medicine prefers optimal—narrower—ranges based on high-functioning, healthy individuals.

3. The Influence of Pharmaceuticals on Lab Criteria

Timestamps: [18:31]–[21:18]

Guidelines and cutoffs for conditions like cholesterol, testosterone, and blood pressure have been repeatedly lowered, in some cases aligning with increased pharmaceutical sales.
Dr. Amie:

“With that flag comes that conversation by your doctor...you really should be on a statin because your cholesterol is high.” ([18:31])
Dr. Berry adds:

“Anytime they can get a lab normal range lowered or raised so that they make more money…they’re going to do that of course.” ([23:00])

4. The Importance of Patient Advocacy and “Lab Literacy”

Timestamps: [23:00]–[26:16]

Physicians are overwhelmed and cannot keep up with new literature; patients bringing research isn’t a threat but a help (in an ideal world).
Most doctors receive minimal education in which labs to order or how to interpret them beyond scanning for “flagged” results.
Patients should understand their test results and know which ones to ask for—this is 'lab literacy.’

5. Key Labs to Request (Especially for Thyroid & Metabolic Health)

Timestamps: [27:19]–[33:29], [41:43]–[51:14]

Essential Baseline Tests

TSH (Thyroid Stimulating Hormone)
Free T4 and Free T3:
Free T3 is the “active” thyroid hormone; some doctors resist ordering it, but it’s crucial to assess true thyroid health.
Reverse T3:
Indicates thyroid dysfunction in the context of stress, chronic illness, or metabolic disruption; rarely checked by conventional docs.
TPO & TG Antibodies:
Detect Hashimoto’s or other autoimmune thyroiditis; a slight elevation is still meaningful.
Fasting Insulin:
Dr. Berry’s favorite information-rich test for metabolic health—can predict diabetes risk years in advance.

Notable Quotes

Dr. Berry:

“If your fasting insulin is above 10, you’re mildly hyperinsulinemic. …But optimal is you really want to eat low carb enough to get it down to about 5.” ([32:18])
On thyroid panels:

“If we have three or more symptoms of thyroid disease…you need to check a full thyroid panel…That’s going to catch 99% of thyroid disease.” ([41:43])

6. Barriers to Proper Lab Ordering and Interpretation

Timestamps: [27:19]–[34:43]

Doctors may refuse tests not because they’re unnecessary, but due to habit, lack of understanding, insurance/cost, or inability to "treat" the abnormal result with a drug (“If there’s not a pharmaceutical to prescribe, many PCPs dismiss the test”).
Most physicians are more comfortable writing prescriptions than engaging in diet/lifestyle counseling, which takes more time and isn't incentivized.

7. How and When to Prepare for Lab Tests

Timestamps: [51:14]–[55:36]

Best practice: Fast for 12–14 hours before labs.
Dr. Berry:

“Always fast at least 12 to 14 hours before any lab result.” ([52:41])
For thyroid panels, test 18–24 hours after last thyroid medication dose (especially T3-containing meds) to avoid false high results.
Labs should be drawn consistently (ex: always after the same length fast and at the same interval from medications).

8. High-Impact Patient Advocacy: “The Nuclear Option”

Timestamps: [56:00]–[60:28]

If your doctor refuses critical labs (like reverse T3, antibodies, or fasting insulin), use this assertive, professional script:

“Doctor, I’m a rational, competent patient. I have researched this. I believe I have a serious medical condition. I need for you to document in my permanent medical record that I have these concerns, I voiced them, and you refused to order these tests. I’ll need a copy before I leave.” ([56:00])
Most doctors will comply to avoid litigation, or you’ll know it’s time to find a new provider.

Why This Matters

Dr. Berry:

“You have just changed the way that person practices medicine for the rest of their career. You have affected the health of every patient that doctor will see for the next 20 years.” ([56:41])

9. The Partnership Model: You Deserve Informed Consent

Timestamps: [60:39]–[63:00]

Doctors are your “learned health partners”—not bosses or gatekeepers.
You have the right to request tests, treatments, and information before consenting.
Dr. Berry:

“If you're about to start...levothyroxine, you need to know, you need to be informed, what are the possible side effects? What are the possible bad outcomes? ...You have an absolute right to be informed before you give your consent for any procedure, any pharmaceutical, or anything.” ([62:17])

Notable Quotes & Memorable Moments

Dr. Amie: “If they don’t ask you the four most important words they can ask—how do you feel?—you leave, you’re done, you’re gone.” ([12:47])
Dr. Berry: “Doctors are just dudes and chicks, okay? ...They’re just people, just like you and me.” ([23:00])
Dr. Berry (on fasting insulin): “Why would you not want to know what my insulin level is, dummy?” ([31:05])
Dr. Berry: “I didn't take an oath to take care of, protect, and defend doctors. ...My oath is to the patients.” ([34:37], [37:46])

Recommended Actions for Listeners

Be proactive: Learn your labs and symptoms; don’t accept “you’re fine” if you feel unwell.
Ask for comprehensive thyroid & metabolic panels: Include TSH, Free T4, Free T3, Reverse T3, TPO, TG antibodies, fasting insulin.
Prepare for your labs properly: Fast as directed; test thyroid labs at the right time relative to meds.
Advocate assertively: If refused, use documentation requests (“nuclear option”) as leverage.
Value the partnership: Doctors should work with you, not above or against you.
Seek optimal health, not just “normal” by outdated or unhealthy standards.

Where to Learn More

Dr. Ken Berry’s Books:
- Common Sense Labs
- Lies My Doctor Told Me
- Kicking Ass After 50
YouTube: Search “Dr Berry” + your condition (e.g., “Dr Berry hypothyroidism”) for direct access to his info. ([64:35])
Social Media: Instagram, Facebook, Twitter/X, TikTok [@KenDBerryMD]

This episode is essential listening for anyone confused or frustrated by unhelpful doctor visits, “normal” lab results that don’t match how they feel, or anyone seeking to truly optimize—not just "normalize"—their thyroid and metabolic health.

For timestamped deep dives:

[10:17] "Symptoms as important as labs"
[14:23] "How lab ranges are set"
[18:31] "Are ranges pharma-influenced?"
[27:19] "Why docs reject certain labs"
[32:18] "Optimal fasting insulin ranges"
[41:43] "Must-include thyroid labs"
[51:14] "Proper lab preparation"
[56:00] "The Nuclear Option (patient advocacy tool)"
[60:39] "Doctors as partners—informed consent"

“You need to know how your body works and what all this means for you with your labs.” – Dr. Amie Hornaman ([63:22])

Podcast Summary: The Thyroid Fixer – Episode 574

Episode Overview

Key Discussion Points & Insights

1. The Limitations of Conventional Medicine and Lab Ranges

Timestamps: [07:27]–[09:11], [14:23]–[16:33]

Conventional doctors often focus more on impressing patients or following systemized routines than actually listening and communicating actionable information.
Many lab reference ranges are based on outdated cohorts (often unhealthy, average Americans from decades past) and may reflect what’s “normal for a sick population,” not optimal health.
Dr. Berry emphasizes,

“The patient's symptoms are just as important, if not in many cases more important than the lab results.” ([10:17])
Labs are most useful when combined with detailed symptom histories; dismissing symptoms in favor of “normal” labs is a red flag.

2. How Lab Reference Ranges are Defined (And Why They’re Flawed)

Timestamps: [14:23]–[16:33]

Labs like LabCorp and Quest determine ranges by sampling 100–500 “healthy-appearing” people, finding a statistical average, and setting reference limits.
Most reference ranges come from people eating the Standard American Diet and may skew toward unhealthy baselines.
Dr. Berry:

“That is normal for a sick population, but it is not normal and indeed very not ideal if you’re trying to achieve optimal health.” ([16:11])
Functional medicine prefers optimal—narrower—ranges based on high-functioning, healthy individuals.

3. The Influence of Pharmaceuticals on Lab Criteria

Timestamps: [18:31]–[21:18]

Guidelines and cutoffs for conditions like cholesterol, testosterone, and blood pressure have been repeatedly lowered, in some cases aligning with increased pharmaceutical sales.
Dr. Amie:

“With that flag comes that conversation by your doctor...you really should be on a statin because your cholesterol is high.” ([18:31])
Dr. Berry adds:

“Anytime they can get a lab normal range lowered or raised so that they make more money…they’re going to do that of course.” ([23:00])

4. The Importance of Patient Advocacy and “Lab Literacy”

Timestamps: [23:00]–[26:16]

Physicians are overwhelmed and cannot keep up with new literature; patients bringing research isn’t a threat but a help (in an ideal world).
Most doctors receive minimal education in which labs to order or how to interpret them beyond scanning for “flagged” results.
Patients should understand their test results and know which ones to ask for—this is 'lab literacy.’

5. Key Labs to Request (Especially for Thyroid & Metabolic Health)

Timestamps: [27:19]–[33:29], [41:43]–[51:14]

Essential Baseline Tests

TSH (Thyroid Stimulating Hormone)
Free T4 and Free T3:
Free T3 is the “active” thyroid hormone; some doctors resist ordering it, but it’s crucial to assess true thyroid health.
Reverse T3:
Indicates thyroid dysfunction in the context of stress, chronic illness, or metabolic disruption; rarely checked by conventional docs.
TPO & TG Antibodies:
Detect Hashimoto’s or other autoimmune thyroiditis; a slight elevation is still meaningful.
Fasting Insulin:
Dr. Berry’s favorite information-rich test for metabolic health—can predict diabetes risk years in advance.

Notable Quotes

Dr. Berry:

“If your fasting insulin is above 10, you’re mildly hyperinsulinemic. …But optimal is you really want to eat low carb enough to get it down to about 5.” ([32:18])
On thyroid panels:

“If we have three or more symptoms of thyroid disease…you need to check a full thyroid panel…That’s going to catch 99% of thyroid disease.” ([41:43])

6. Barriers to Proper Lab Ordering and Interpretation

Timestamps: [27:19]–[34:43]

Doctors may refuse tests not because they’re unnecessary, but due to habit, lack of understanding, insurance/cost, or inability to "treat" the abnormal result with a drug (“If there’s not a pharmaceutical to prescribe, many PCPs dismiss the test”).
Most physicians are more comfortable writing prescriptions than engaging in diet/lifestyle counseling, which takes more time and isn't incentivized.

7. How and When to Prepare for Lab Tests

Timestamps: [51:14]–[55:36]

Best practice: Fast for 12–14 hours before labs.
Dr. Berry:

“Always fast at least 12 to 14 hours before any lab result.” ([52:41])
For thyroid panels, test 18–24 hours after last thyroid medication dose (especially T3-containing meds) to avoid false high results.
Labs should be drawn consistently (ex: always after the same length fast and at the same interval from medications).

8. High-Impact Patient Advocacy: “The Nuclear Option”

Timestamps: [56:00]–[60:28]

If your doctor refuses critical labs (like reverse T3, antibodies, or fasting insulin), use this assertive, professional script:

“Doctor, I’m a rational, competent patient. I have researched this. I believe I have a serious medical condition. I need for you to document in my permanent medical record that I have these concerns, I voiced them, and you refused to order these tests. I’ll need a copy before I leave.” ([56:00])
Most doctors will comply to avoid litigation, or you’ll know it’s time to find a new provider.

Why This Matters

Dr. Berry:

“You have just changed the way that person practices medicine for the rest of their career. You have affected the health of every patient that doctor will see for the next 20 years.” ([56:41])

9. The Partnership Model: You Deserve Informed Consent

Timestamps: [60:39]–[63:00]

Doctors are your “learned health partners”—not bosses or gatekeepers.
You have the right to request tests, treatments, and information before consenting.
Dr. Berry:

“If you're about to start...levothyroxine, you need to know, you need to be informed, what are the possible side effects? What are the possible bad outcomes? ...You have an absolute right to be informed before you give your consent for any procedure, any pharmaceutical, or anything.” ([62:17])

Notable Quotes & Memorable Moments

Dr. Amie: “If they don’t ask you the four most important words they can ask—how do you feel?—you leave, you’re done, you’re gone.” ([12:47])
Dr. Berry: “Doctors are just dudes and chicks, okay? ...They’re just people, just like you and me.” ([23:00])
Dr. Berry (on fasting insulin): “Why would you not want to know what my insulin level is, dummy?” ([31:05])
Dr. Berry: “I didn't take an oath to take care of, protect, and defend doctors. ...My oath is to the patients.” ([34:37], [37:46])

Recommended Actions for Listeners

Be proactive: Learn your labs and symptoms; don’t accept “you’re fine” if you feel unwell.
Ask for comprehensive thyroid & metabolic panels: Include TSH, Free T4, Free T3, Reverse T3, TPO, TG antibodies, fasting insulin.
Prepare for your labs properly: Fast as directed; test thyroid labs at the right time relative to meds.
Advocate assertively: If refused, use documentation requests (“nuclear option”) as leverage.
Value the partnership: Doctors should work with you, not above or against you.
Seek optimal health, not just “normal” by outdated or unhealthy standards.

Where to Learn More

Dr. Ken Berry’s Books:
- Common Sense Labs
- Lies My Doctor Told Me
- Kicking Ass After 50
YouTube: Search “Dr Berry” + your condition (e.g., “Dr Berry hypothyroidism”) for direct access to his info. ([64:35])
Social Media: Instagram, Facebook, Twitter/X, TikTok [@KenDBerryMD]

This episode is essential listening for anyone confused or frustrated by unhelpful doctor visits, “normal” lab results that don’t match how they feel, or anyone seeking to truly optimize—not just "normalize"—their thyroid and metabolic health.

For timestamped deep dives:

[10:17] "Symptoms as important as labs"
[14:23] "How lab ranges are set"
[18:31] "Are ranges pharma-influenced?"
[27:19] "Why docs reject certain labs"
[32:18] "Optimal fasting insulin ranges"
[41:43] "Must-include thyroid labs"
[51:14] "Proper lab preparation"
[56:00] "The Nuclear Option (patient advocacy tool)"
[60:39] "Doctors as partners—informed consent"

“You need to know how your body works and what all this means for you with your labs.” – Dr. Amie Hornaman ([63:22])

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Summary

Podcast Summary: The Thyroid Fixer – Episode 574

Episode Overview

Key Discussion Points & Insights

1. The Limitations of Conventional Medicine and Lab Ranges

2. How Lab Reference Ranges are Defined (And Why They’re Flawed)

3. The Influence of Pharmaceuticals on Lab Criteria

4. The Importance of Patient Advocacy and “Lab Literacy”

5. Key Labs to Request (Especially for Thyroid & Metabolic Health)

Essential Baseline Tests

Notable Quotes

6. Barriers to Proper Lab Ordering and Interpretation

7. How and When to Prepare for Lab Tests

8. High-Impact Patient Advocacy: “The Nuclear Option”

Why This Matters

9. The Partnership Model: You Deserve Informed Consent

Notable Quotes & Memorable Moments

Recommended Actions for Listeners

Where to Learn More

This episode is essential listening for anyone confused or frustrated by unhelpful doctor visits, “normal” lab results that don’t match how they feel, or anyone seeking to truly optimize—not just "normalize"—their thyroid and metabolic health.

Summary

Podcast Summary: The Thyroid Fixer – Episode 574

Episode Overview

Key Discussion Points & Insights

1. The Limitations of Conventional Medicine and Lab Ranges

2. How Lab Reference Ranges are Defined (And Why They’re Flawed)

3. The Influence of Pharmaceuticals on Lab Criteria

4. The Importance of Patient Advocacy and “Lab Literacy”

5. Key Labs to Request (Especially for Thyroid & Metabolic Health)

Essential Baseline Tests

Notable Quotes

6. Barriers to Proper Lab Ordering and Interpretation

7. How and When to Prepare for Lab Tests

8. High-Impact Patient Advocacy: “The Nuclear Option”

Why This Matters

9. The Partnership Model: You Deserve Informed Consent

Notable Quotes & Memorable Moments

Recommended Actions for Listeners

Where to Learn More

This episode is essential listening for anyone confused or frustrated by unhelpful doctor visits, “normal” lab results that don’t match how they feel, or anyone seeking to truly optimize—not just "normalize"—their thyroid and metabolic health.