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Simon Senanu: ‘Within Range’ Is Not the Same as ‘Safe’ in Laboratory Medicine
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Feb 13, 2026, 12:49

Simon Senanu: ‘Within Range’ Is Not the Same as ‘Safe’ in Laboratory Medicine

Simon Senanu, Medical Laboratory Scientist at Perkins Medical Centre, shared a post on LinkedIn.

“The Most Dangerous ‘Normal’ Lab Results – When ‘Within Range’ Is Not the Same as ‘Safe’

Some of the most dangerous lab results are… normal.

Because normal ranges don’t know:

  • the patient
  • the timeline
  • the clinical context

‘Normal’ Creatinine

What the lab shows: Creatinine within reference range.
What may be happening:

  • Early acute kidney injury
  • Significant renal loss in elderly or low-muscle patients

Clinical insight: Creatinine rises late. A ‘normal’ value can mask up to 50% loss of kidney function.
Always interpret with:

  • age
  • muscle mass
  • urine output
  • and trend

‘Normal’ Hemoglobin (Hb)

What the lab shows: Hb within reference range.
What may be happening:

  • Acute blood loss
  • Hemodilution not yet reflected

Clinical insight: Hemoglobin does not fall immediately after acute bleeding.

A normal Hb does not rule out hemorrhage in the first 24 hours.

‘Normal’ White Blood Cell Count (WBC)

What the lab shows: Total WBC within range.

What may be happening:

  • Sepsis (especially in elderly, neonates, immunocompromised)

 Clinical insight: Sepsis can exist with a normal WBC.

Differential count, CRP, procalcitonin, and clinical signs matter more.

 ‘Normal’ Troponin
What the lab shows: Troponin not elevated.

What may be happening:

  • Early myocardial infarction
  • Unstable angina

Clinical insight: Troponin elevation is time-dependent.

A single normal troponin does not exclude ACS – serial testing is essential.

‘Normal’ Sodium
What the lab shows: Sodium within reference range.

What may be happening:

  • Rapid correction of previous hyponatremia or hypernatremia

 Clinical insight: The rate of change is often more dangerous than the value itself.

Normal today doesn’t mean safe yesterday.

 ‘Normal’ INR
What the lab shows: INR within range.

What may be happening:

  • High bleeding risk due to thrombocytopenia
  • Liver disease with balanced factor loss

Clinical insight: INR measures one part of hemostasis.

Normal INR does not mean normal clotting.

Clinical Reality
Reference ranges describe populations – not patients.

‘Normal’ values can still hide:

  • early disease
  • rapid deterioration
  • life-threatening pathology

Pro Tip
Always ask:

  1. Is this the right time?
  2. Is this the right patient?
  3. Is this the right trend?

Single numbers mislead. Patterns save lives.

Which ‘normal’ lab result has caused the most harm in your clinical experience?”

Simon Senanu: 'Within Range' Is Not the Same as 'Safe' in Laboratory Medicine

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acute kidney injury blood loss Creatinine Early myocardial infarction Health Hematology Hemoglobin (Hb) Hemostasis Hemostasis News Hemostasis Today Medicine Simon Senanu troponin White Blood Cell Count (WBC)
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