So Called "Normal Labs" are NOT Healthy

Berg compares the situation to having a dam holding back a flood: glucose is the water level, insulin is the dam. As long as the dam holds, glucose looks fine, but the pressure on the dam (insulin) is immense. He notes that even when insulin is tested, doctors often accept values like 12 μIU/mL as normal. He bases his recommendations on research and his clinical experience. The HOMA-IR index adds prognostic power by modeling how well insulin is working relative to glucose. For someone with fasting glucose of 95 mg/dL and insulin of 10, HOMA-IR would be 2.35, indicating insulin resistance. A value below 1.0 is considered optimal. Early detection enables low-carb and intermittent fasting interventions that can reverse insulin resistance before permanent beta-cell damage occurs.

Berg explains that many people with insulin resistance see high morning blood sugar and wonder why, since they didn't eat carbohydrates the night before. He says that in severe insulin resistance, up to 80% of blood glucose can come from the liver's own production. The solution is to address the root cause: carbohydrate intake. By cutting carbs and implementing intermittent fasting, the liver's sensitivity to insulin improves, and the inappropriate gluconeogenesis subsides. He suggests monitoring morning blood sugar and staying the course until it normalizes. He also mentions that a morning walk is a practical tool to bring down the immediate high glucose while the dietary changes take effect.

Berg states that so many people are inflamed and that average CRP is not healthy. He disagrees with doctors who say below 3 is fine, arguing that even 1.8 is a low-grade inflammatory state that should be addressed. The interventions he recommends are broad lifestyle changes centered on removing inflammatory triggers and adding anti-inflammatory nutrients. He specifically mentions cod liver oil as a preferred omega-3 source. He frames this as part of a larger pattern where 'normal' does not mean 'healthy.'

Berg emphasizes that the confusion around LDL arises because cholesterol is essential (the body makes it) and LDL is simply a delivery vehicle. The real issue is particle quality. He notes that people on a low-carb diet often see cholesterol levels rise because they are mobilizing fat for fuel, and the lipids in transit show up in blood work. A standard test may then alarm them or their doctor unnecessarily. The specialized test reveals whether the LDL is the benign Pattern A or the dangerous Pattern B. He also mentions that he has created a simplified video to help understand this topic, underscoring how muddled the public narrative is. His message: don't panic about high cholesterol; find out what kind of LDL you have.

Berg calls vitamin D resistance something that 'a lot of even doctors don't know.' He explains that if someone's vitamin D is, say, 30 ng/mL (often labeled sufficient) yet PTH is elevated, the body is essentially compensating for a lack of active vitamin D. He advises aiming for levels of 50–70 ng/mL and notes that the 20 ng/mL threshold is 'ridiculously too low,' based only on rickets prevention. He also brings up the RDA miscalculation where the actual requirement to hit 20 ng/mL is nearly 9,000 IU, not 600 IU, and that many doctors wrongly deem moderate doses toxic. He mentions having created 284 videos on vitamin D, signaling deep expertise on the subject.

Berg points out that the standard blood cortisol test is a snapshot that misses the full picture. The saliva test, though a bit of a hassle, gives the full curve and is the gold standard for non-invasive ambulatory cortisol assessment. He acknowledges the inconvenience of waking up in the middle of the night to collect saliva, but notes that HRV technology has advanced significantly and is now widely available in consumer wearables like watches, chest straps, and rings. This provides an accessible way to monitor stress and recovery indirectly, making it a practical alternative for many people. He presents this as another case where conventional single-point testing fails to detect dysfunction.

Berg argues that when you picture a bell curve of the population's lab values, the 'normal' range is created by chopping off the low and high ends. But as the population gets fatter and sicker, those ranges shift upward into pathology. He states that people are told their labs are normal when they are manifestly unwell—weight issues, hair loss, skin problems—and may even be told 'it's all in your head.' The 1997 glucose threshold change reclassified 1.4 million people as diabetic overnight, and the 2003 pre-diabetes change added 41 million. Berg suggests that trend watchers who see a diabetes explosion may attribute it solely to diet, ignoring that diagnostic criteria were artificially narrowed. The vitamin D RDA error is another example of systemic inaccuracy: the calculation set the requirement at 600 IU to prevent rickets when the true amount needed to maintain a minimal level of 20 ng/mL is nearly 9,000 IU, yet many doctors still deem that dose toxic. This pattern, Berg believes, leads to widespread underdiagnosis of metabolic and nutritional problems and a false sense of security.

Berg explains that insulin's job is to clear glucose from the blood, and the body normally keeps only about one teaspoon of sugar in the entire bloodstream. The average person consumes 50–100 teaspoons of sugar per day, forcing the pancreas to work overtime. As long as insulin can push glucose into cells, fasting glucose stays normal, masking the underlying problem. Eventually cells become resistant to insulin's signal, the pancreas compensates by producing even more, and only after years or decades does the beta-cell burnout cause glucose to rise to pre-diabetic and diabetic levels. A fasting insulin test, along with the HOMA-IR calculation (which combines fasting insulin and glucose), can detect insulin resistance long before glucose becomes abnormal. Berg recommends a fasting insulin target of 2–6 μIU/mL, with concern starting at 8 and high risk at 10–12. He laments that many doctors label an insulin of 12 as 'normal,' missing the opportunity for early intervention.

Berg states that many people with symptoms of vitamin D deficiency—bone pain, immune dysfunction, fatigue—are told their levels are normal. This happens because the blood test does not capture what is happening inside cells, where the active form of vitamin D works. Vitamin D resistance means that despite adequate blood levels, cells do not respond adequately, possibly due to receptor dysfunction or insufficient conversion. The parathyroid gland is sensitive to calcium and vitamin D status; when active vitamin D is low, PTH rises to maintain calcium levels. Therefore, if a person's vitamin D blood test is normal but PTH is high, one can deduce that vitamin D is not working effectively at the tissue level. Berg recommends aiming for serum levels of 50–70 ng/mL, and even higher if using vitamin D therapeutically. He notes that the often-cited 'sufficient' level of 20 ng/mL was set only to prevent rickets, not to support optimal health, and that the RDA for intake is drastically underestimated.

Berg explains that cholesterol does not float freely in blood; it is packaged in lipoproteins. LDL carries cholesterol to tissues. There are two main types of LDL particles: Pattern A are large, fluffy, and do not penetrate the arterial wall, so they are considered non-pathogenic. Pattern B particles are small and dense, can invade the endothelium, and are linked to inflammation and heart disease. He states that people on a low-carb diet tend to have more Pattern A because they mobilize fat and cholesterol for energy, and this is not a cause for alarm. People eating more carbohydrates are more likely to have Pattern B. Thus, a high LDL on a standard test may be harmless or dangerous depending on particle size. Berg recommends getting a specialized lipid profile that measures LDL particle size and number to make informed decisions, and he has created a dedicated video to simplify the topic.

Berg points out that cortisol is on a wave and that checking it at one time of day misses the full picture. He recommends a saliva test that captures the curve at four key time points, though he acknowledges the inconvenience of waking up in the middle of the night to collect a sample. As a more practical alternative, he highlights HRV technology, which measures the balance between sympathetic and parasympathetic activity through heartbeat intervals. HRV devices (watches, chest bands, rings) have become more accessible and can indirectly indicate chronic stress patterns. He suggests that this method can be a useful proxy for adrenal function without the hassle of nighttime saliva collection.